Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FX1800X | Optician | NY | |
Y | 156FX1800X | Optician | 009922 | NY |
NPI | 1144790932 |
---|---|
Provider Name | Ashley Nicole Clair |
First Address | Cortland, NY 13045-8964 |
Second Address | Cortland, NY 13045-8964 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2018 |
Last Update Date | 05/12/2018 |