Provider Demographics
NPI:1285924779
Name:KIRTINITIS-TURKMEN, JOLIE ALICIA (OD)
Entity type:Individual
Prefix:DR
First Name:JOLIE
Middle Name:ALICIA
Last Name:KIRTINITIS-TURKMEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JOLIE
Other - Middle Name:ALICIA
Other - Last Name:KIRTINITIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:190 ROCKCREST RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3735
Mailing Address - Country:US
Mailing Address - Phone:516-627-7637
Mailing Address - Fax:516-627-7637
Practice Address - Street 1:6545 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7028
Practice Address - Country:US
Practice Address - Phone:718-366-7850
Practice Address - Fax:718-366-7851
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005662-1152W00000X
MDTA1314152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist