Shimanova, Olga

Shimanova, Olga is an sole proprietor health care provider with primary practice located at 9102 63 Dr , Rego Park NY 11374-3850. She recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as her primary health care specialty. Shimanova, Olga can be contacted via phone (718) 897-5101.

Contact Information

Primary practice address
9102 63 Dr Rego Park NY 11374-3850
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X 007240-1 New York

Profile Details

NPI number 1396826616
LBN Legal business name Shimanova, Olga
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2006
Last updated Jun 2nd, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396826616 NPPES
New York Other 11554176 CAQH
New York Other NY7240 CAQH
New York MEDICAID 02181708 CAQH

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