Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 5545 | MA |
NPI | 1184027427 |
---|---|
Provider Name | Andrea Tanona |
First Address | Reading, MA 01867-1302 |
Second Address | Amesbury, MA 01913-2404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2014 |
Last Update Date | 01/10/2014 |