MK OPTOMETRIST PC
Ambulatory Health at Selfridge St, Flushing, NY

License number
New York 006662
Category
Ambulatory Health
Type
Health Service
Owner
Name: DR. MICHAEL KAKZANOV O.D.
Title: PRESIDENT
Phone: (718) 268-4040
Address
Address
6677 Selfridge St, Flushing, NY 11375
National Provider ID: 1881883601
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MK OPTOMETRIST PC

Flushing, NY

Registration:
Aug 22, 2007
Addresses:
66-77 Selfridge Rd, Forest Hills, NY 11375 (Physical)
66-77 Selfridge St, Forest Hills, NY 11375 (Physical)
State ID:
3559291
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Mikhail Kakzanov, 66-77 Selfridge St, Forest Hills, NY 11375 (Physical)

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