Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 4287 | MA |
NPI | 1154748978 |
---|---|
Provider Name | Felix Shlosman |
First Address | Brookline, MA 02446-0015 |
Second Address | Brookline, MA 02445-7130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2014 |
Last Update Date | 19/03/2014 |