Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV0070881 | NY |
NPI | 1013089275 |
---|---|
Provider Name | Dr. Judith Archer |
First Address | Ontario, NY 14519 |
Second Address | Victor, NY 14564-1017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 31/10/2011 |