Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008565-1 | NY |
NPI | 1194853184 |
---|---|
Provider Name | David M Weissman |
First Address | Brooklyn, NY 11229-4748 |
Second Address | Brooklyn, NY 11235-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 08/07/2007 |