Individual
MR. YAN KOTLYAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED OPTICIAN
Contact information
Practice address
6 NEWKIRK PLZ, BROOKLYN, NY 11226-6526
(718) 421-7209
(718) 421-7209
Mailing address
6 NEWKIRK PLZ, BROOKLYN, NY 11226-6526
(718) 421-7209
(718) 421-7209
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
7361
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740385194
—
NY
Enumeration date
04/18/2012
Last updated
04/18/2012
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