Provider Demographics
NPI:1699243600
Name:PRESMAN, MARINA (DOCTOR OF OPTOMETRY)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:PRESMAN
Suffix:
Gender:F
Credentials:DOCTOR OF OPTOMETRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 QUEENS BLVD
Mailing Address - Street 2:STE 1029
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4914
Mailing Address - Country:US
Mailing Address - Phone:347-249-3605
Mailing Address - Fax:
Practice Address - Street 1:16111 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6113
Practice Address - Country:US
Practice Address - Phone:347-249-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008903152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty