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General NPI Number Information
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NPI Number | 1801264767
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Entity Type | Individual
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Provider Name | MRS. EVA SHMUKLYER
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Gender | Female
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 7000 AUSTIN ST SUITE 200
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City | FOREST HILLS
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State | NY
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Zip | 11375-1022
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Country | US
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Telephone | 718-762-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 1395 BROADWAY A4
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City | HEWLETT
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State | NY
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Zip | 11557-1326
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Country | US
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Telephone | 516-551-5271
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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