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General NPI Number Information
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NPI Number | 1083851844
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Entity Type | Organization
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Legal Business Name | JBKM, LLC
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 8811 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2039
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Country | US
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Telephone | 718-847-4222
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Fax | 718-441-4117
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Provider Business Mailing Address
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Address Line | 8811 JAMAICA AVE
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City | WOODHAVEN
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State | NY
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Zip | 11421-2039
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Country | US
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Telephone | 718-847-4222
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Fax | 718-441-4117
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KAMAL ZAFAR
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Credential |
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Telephone | 718-847-4222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV002516
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License Number State | NY
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