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Individual

JORGE LUIS PADILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9522 37TH AVE, JACKSON HEIGHTS, NY 11372-8020
(718) 429-2020
(718) 429-2300
Mailing address
9522 37TH AVE, JACKSON HEIGHTS, NY 11372-8020
(718) 429-2020
(718) 429-2300

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
005844
NY
152W00000X
Optometrist
Primary
006568
NY

Other

Enumeration date
12/05/2023
Last updated
12/05/2023
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