Individual
DR. DMITRY GUREVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1913 KINGS HWY, BROOKLYN, NY 11229-1313
(917) 933-9090
Mailing address
139 VAN SICKLEN ST, BROOKLYN, NY 11223-2750
(917) 449-0479
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
005953
NY
152W00000X
Optometrist
Primary
VUT005953
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02118174
—
NY
Enumeration date
11/21/2006
Last updated
03/13/2020
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