Provider Demographics
NPI:1861755027
Name:HOLZMAN, RACHEL MELISSA (OD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MELISSA
Last Name:HOLZMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11029 67TH DR
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2947
Mailing Address - Country:US
Mailing Address - Phone:718-793-5682
Mailing Address - Fax:
Practice Address - Street 1:82-02 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-2947
Practice Address - Country:US
Practice Address - Phone:718-502-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007846152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist