Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV004286-1 | NY |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | TUV004286-1 | NY |
NPI | 1255419180 |
---|---|
Provider Name | Arlene Edith Minkoff |
First Address | Holbrook, NY 11741-4309 |
Second Address | Holbrook, NY 11741-4309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 01/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V07703 | (02) |