Individual
MRS. INNA MEDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED OPTICIAN
Contact information
Practice address
423 FULTON ST, BROOKLYN, NY 11201-5121
(718) 522-5656
(718) 522-6444
Mailing address
423 FULTON ST, BROOKLYN, NY 11201-5121
(718) 522-5656
(718) 522-6444
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006195-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02491096
—
NY
Enumeration date
03/19/2008
Last updated
03/19/2008
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