Individual
SUSAN SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
854 UTICA AVE, BROOKLYN, NY 11203-3481
(718) 240-6649
Mailing address
24518 134TH AVE, ROSEDALE, NY 11422-1427
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT006933
NY
Other
Enumeration date
02/03/2007
Last updated
03/10/2020
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