Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | C-007816 | NY |
NPI | 1205908555 |
---|---|
Provider Name | Avraham C Vizel |
First Address | Brooklyn, NY 11210-4639 |
Second Address | Brooklyn, NY 11210-4639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 12/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02098539 | (05) | NY |
02098557 | (05) | NY |