Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV008587-1 | NY |
NPI | 1013437599 |
---|---|
Provider Name | Emily Crane |
First Address | New York, NY 10016-5041 |
Second Address | New York, NY 10036-8005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2017 |
Last Update Date | 26/06/2017 |