Provider Demographics
NPI:1699127670
Name:BABAYEVA, MILANA (OD)
Entity type:Individual
Prefix:
First Name:MILANA
Middle Name:
Last Name:BABAYEVA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3781 JUNCTION BLVD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-1740
Mailing Address - Country:US
Mailing Address - Phone:718-551-4495
Mailing Address - Fax:
Practice Address - Street 1:3781 JUNCTION BLVD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-1740
Practice Address - Country:US
Practice Address - Phone:718-446-1333
Practice Address - Fax:718-446-1336
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008486152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist