Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner |
NPI | 1720446560 |
---|---|
Provider Name | Albert Cirino |
First Address | Van Nuys, CA 91405-4435 |
Second Address | Van Nuys, CA 91405-4435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2016 |
Last Update Date | 08/02/2016 |