| Doctor Name: | ISAAK SHARIVKER |
| NPI Number: | 1003883505 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OPTICIAN |
| License Number: | 006712-1 |
| Business Practice Address: | 11212 Queens Blvd Forest Hills, NY - 113756344 |
| Business Phone Number: | 7182611764 |
| Business Fax Number: | 7182611764 |
| Mailing Address: | 11212 Queens Blvd, FOREST HILLS |
| State: | NY |
| Postal Code: | 113756344 |
| Phone Number: | 7182611764 |
| Fax Number: | 7182611764 |
| NPI Enumeration Date: | 03/02/2006 |
| NPI Last Update Date: | 04/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 006712-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |