Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | C5339 | NY |
N | 156FX1800X | Optician | C5339 | NY |
NPI | 1215156971 |
---|---|
Provider Name | Edward Shierly |
First Address | Binghamton, NY 13905-3107 |
Second Address | Binghamton, NY 13905-3107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |