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General NPI Number Information
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NPI Number | 1477703577
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Entity Type | Organization
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Legal Business Name | KEW GARDENS OPTOMETRY, P.C.
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 10304 ROOSEVELT AVE
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City | CORONA
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State | NY
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Zip | 11368-2330
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Country | US
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Telephone | 718-424-1333
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Fax | 718-424-1330
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Provider Business Mailing Address
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Address Line | 10304 ROOSEVELT AVE
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City | CORONA
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State | NY
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Zip | 11368-2330
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Country | US
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Telephone | 718-424-1333
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Fax | 718-424-1330
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PEZHMAN HOURIZADEH
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Credential | O.D.
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Telephone | 718-263-2020
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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 |
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License Number State |
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