Provider Demographics
NPI:1780114140
Name:MERAKOV, SOLOMON (OPTICIAN)
Entity type:Individual
Prefix:
First Name:SOLOMON
Middle Name:
Last Name:MERAKOV
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 1:18919 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1861
Mailing Address - Country:US
Mailing Address - Phone:718-470-2301
Mailing Address - Fax:718-470-2439
Practice Address - Street 1:18919 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1861
Practice Address - Country:US
Practice Address - Phone:718-470-2301
Practice Address - Fax:718-470-2439
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007501-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty