Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | T4013 | NY |
NPI | 1013055805 |
---|---|
Provider Name | Joel Rosenstraus |
First Address | Howard Beach, NY 11414 |
Second Address | Howard Beach, NY 11414-3431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 21/09/2011 |