Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 6802 | NY |
NPI | 1225262769 |
---|---|
Provider Name | Christine Ann Dean |
First Address | Hudson, NY 12534-1314 |
Second Address | Hudson, NY 12534-1314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2009 |
Last Update Date | 13/05/2009 |