=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912579350
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DINA FRANKLIN, O.D., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2021
-----------------------------------------------------
Last Update Date | 07/14/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 218 LAKEVILLE RD
-----------------------------------------------------
City | GREAT NECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11020-1400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-209-6409
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 476 DUNSTER DR
-----------------------------------------------------
City | WEST HEMPSTEAD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11552-2807
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-209-6409
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPTOMETRIST
-----------------------------------------------------
Name | DR. DINA FRANKLIN
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 646-209-6409
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------