Individual
SUCHI MATALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1336 COATES AVE, HOLBROOK, NY 11741-2424
(631) 609-5759
Mailing address
1336 COATES AVE, HOLBROOK, NY 11741-2424
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007910-1
NY
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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