Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 007413 | NY |
NPI | 1043452626 |
---|---|
Provider Name | David Bruce Cameron |
First Address | Burnt Hills, NY 12027-0209 |
Second Address | Burnt Hills, NY 12027-0209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2009 |
Last Update Date | 30/03/2009 |