Healthcare Provider Details

I. General information

NPI: 1023284833
Provider Name (Legal Business Name): ALIYA HOT O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E 121ST ST
NEW YORK NY
10035-3047
US

IV. Provider business mailing address

203 E 121ST ST
NEW YORK NY
10035-3047
US

V. Phone/Fax

Practice location:
  • Phone: 212-876-2957
  • Fax:
Mailing address:
  • Phone: 212-876-2957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number007232
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: