Provider Demographics
NPI:1174845044
Name:SMOTRITSKIY, FELIX (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:SMOTRITSKIY
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4002
Mailing Address - Country:US
Mailing Address - Phone:212-481-6690
Mailing Address - Fax:212-481-6690
Practice Address - Street 1:430 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4002
Practice Address - Country:US
Practice Address - Phone:212-481-6690
Practice Address - Fax:212-481-6690
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007557-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician