| Doctor Name: | MR. ALEKSANDR SHIMUNOV |
| NPI Number: | 1003162280 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OPTITION |
| License Number: | 007474-1 |
| Business Practice Address: | 471 E Tremont Ave Bronx, NY - 104574401 |
| Business Phone Number: | 9172046655 |
| Business Fax Number: | 9178193240 |
| Mailing Address: | 471 E Tremont Ave, BRONX |
| State: | NY |
| Postal Code: | 104574401 |
| Phone Number: | 9172046655 |
| Fax Number: | 9178193240 |
| NPI Enumeration Date: | 07/25/2012 |
| NPI Last Update Date: | 07/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156F00000X |
| License Number: | 007474-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |