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General NPI Number Information
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NPI Number | 1780988113
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Entity Type | Organization
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Legal Business Name | NAOMI R. KNOLLER, O.D., P.C.
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 40 SAW MILL RIVER RD STE FB2
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City | HAWTHORNE
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State | NY
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Zip | 10532-1528
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Country | US
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Telephone | 914-579-2344
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Fax | 914-579-2346
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Provider Business Mailing Address
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Address Line | 40 SAW MILL RIVER RD STE FB2
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City | HAWTHORNE
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State | NY
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Zip | 10532-1528
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Country | US
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Telephone | 914-579-2344
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Fax | 914-579-2346
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Authorized Official
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Title or Position | OFFICER/SHAREHOLDER
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Name | DR. NAOMI R. KNOLLER
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Credential | O.D.
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Telephone | 914-579-2344
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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 | TUV005003-1
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License Number State | NY
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