Kakzanov, Roman S
Kakzanov, Roman S is an individual health care provider with primary practice located at 119-15 Atlantic Avenue , Richmond Hill NY 11418. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kakzanov, Roman S can be contacted via phone (718) 805-0700.Contact Information
Primary practice address
119-15 Atlantic Avenue
Richmond Hill NY 11418
Phone: (718) 805-0700
Fax: (718) 805-5621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TUV008183-1 | New York |
Profile Details
| NPI number | 1760897383 |
|---|---|
| LBN Legal business name | Kakzanov, Roman S |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2014 |
| Last updated | Sep 20th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760897383 | NPPES |
| New York | MEDICAID | 03966603 |
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