Individual
BORIS TAKHALOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
111 HEMPSTEAD TPKE, INSIDE NWL, WEST HEMPSTEAD, NY 11552-2155
(516) 493-9323
Mailing address
40 N FRANKLIN ST, INSIDE NWL, HEMPSTEAD, NY 11550-2155
(516) 493-9323
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
009414-1
NY
Other
Enumeration date
12/11/2012
Last updated
05/07/2019
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