Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV008500-1 | NY |
NPI | 1003360280 |
---|---|
Provider Name | Jenny Bartov |
First Address | Brooklyn, NY 11229-3350 |
Second Address | Brooklyn, NY 11229-3350 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2016 |
Last Update Date | 05/08/2016 |