Provider Demographics
NPI:1538848593
Name:ANNA KHESIN OPTOMETRY PC
Entity type:Organization
Organization Name:ANNA KHESIN OPTOMETRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHESIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-480-8412
Mailing Address - Street 1:11402 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2442
Mailing Address - Country:US
Mailing Address - Phone:718-480-8412
Mailing Address - Fax:718-480-8414
Practice Address - Street 1:11402 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2442
Practice Address - Country:US
Practice Address - Phone:718-480-8412
Practice Address - Fax:718-480-8414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty