MEDICARE: DR. SEVADA HAKOBYAN 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
1	152W00000X	Optometrist	009065	NY

General Provider Information

NPI Number	:	1881236669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEVADA HAKOBYAN OD

Provider Business Mailing Address
First Line	:	3410 84TH ST APT H2
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-3126
Country	:	US
Telephone Number	:	216-571-5933
Fax Number	:

Provider Business Practice Location Address
First Line	:	3457 82ND ST STE 1F
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-2930
Country	:	US
Telephone Number	:	718-446-8100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2019
Last Update Date	:	10/13/2019

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