Healthcare Provider Details

I. General information

NPI: 1306096169
Provider Name (Legal Business Name): ZLATIN OPTOMETRIST, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 04/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 WILMOT RD
SCARSDALE NY
10583
US

IV. Provider business mailing address

1130 WILMOT RD
SCARSDALE NY
10583
US

V. Phone/Fax

Practice location:
  • Phone: 914-472-5932
  • Fax: 914-472-7485
Mailing address:
  • Phone: 914-472-5932
  • Fax: 914-472-7485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ABRAHAM ZLATIN
Title or Position: PRES./OPTOMETRIST
Credential: OD
Phone: 914-472-5932