Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist | 090113 | NY |
NPI | 1295830552 |
---|---|
Provider Name | Dr. Manuel Francisco |
First Address | Scotia, NY 12302-4722 |
Second Address | Scotia, NY 12302-4722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B06703 | (02) | NY |