Individual
SUKAYNA ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3456 FAIRLANE DR, UNIT 104, ALLEN PARK, MI 48101-2873
(210) 245-2226
Mailing address
3456 FAIRLANE DR, UNIT 104, ALLEN PARK, MI 48101-2873
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004991
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4901004991
—
MI
Enumeration date
07/08/2016
Last updated
07/08/2016
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