Provider Demographics
NPI:1841660107
Name:NAWLO, JOSEPH (OD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:NAWLO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201A DYCKMAN ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-1068
Mailing Address - Country:US
Mailing Address - Phone:212-304-0020
Mailing Address - Fax:212-304-3852
Practice Address - Street 1:201A DYCKMAN ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-1068
Practice Address - Country:US
Practice Address - Phone:212-304-0020
Practice Address - Fax:212-304-3852
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC009396156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician