| Doctor Name: | KRISTIN ANN PROTOSOW |
| NPI Number: | 1063688547 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OPTOMETRIST, OD |
| License Number: | TUV007254-1 |
| Business Practice Address: | 624 Hawkins Ave Suite 1 Ronkonkoma, NY - 117792375 |
| Business Phone Number: | 6315885100 |
| Business Fax Number: | 6315885185 |
| Mailing Address: | 624 Hawkins Ave., Suite 1 RONKONKOMA |
| State: | NY |
| Postal Code: | 11779 |
| Phone Number: | 6315885100 |
| Fax Number: | 6315885185 |
| NPI Enumeration Date: | 05/05/2008 |
| NPI Last Update Date: | 11/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WL0500X |
| License Number: | TUV007254-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Low Vision Rehabilitation |
| Taxonomy Definition: | Optometrists who specialize in low-vision care having training to assess visual function, prescribe low-vision devices, develop treatment plans, and recommend other vision rehabilitation services. |