Individual
MR. IOSIF IFRAIMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
482 CENTRAL AVE, CEDARHURST, NY 11516-2007
(516) 792-5656
Mailing address
482 CENTRAL AVE, CEDARHURST, NY 11516-2007
(516) 792-5656
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
009518
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-3299832
RESALE CERTIFICATE
NY
Enumeration date
02/01/2018
Last updated
06/16/2018
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