Organization
MDS OPTOMETRY AND OPHTHALMIC DISPENSING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHEAL KAKZANOV (OWNER)
(212) 217-1600
Entity
Organization
Contact information
Practice address
1566A 1ST AVE, NEW YORK, NY 10028-4004
(212) 217-1600
Mailing address
1566A 1ST AVE, NEW YORK, NY 10028-4004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/08/2014
Last updated
09/12/2014
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