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NPI Code Detail

MEDICARE: DR. RACHAIL AVIZOVA OD

MEDICARE:  DR. RACHAIL  AVIZOVA  OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist011087NY

General Provider Information

NPI Number : 1851114334
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHAIL AVIZOVA OD
Provider Business Mailing Address
First Line : 1566A 1ST AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10028-4004
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1566A 1ST AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10028-4004
Country : US
Telephone Number : 347-335-2116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2024
Last Update Date : 12/26/2024

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Directions to “ DR. RACHAIL AVIZOVA OD” Practice Location

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