Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 007557-1 | NY |
NPI | 1174845044 |
---|---|
Provider Name | Felix Smotritskiy |
First Address | New York, NY 10010-4002 |
Second Address | New York, NY 10010-4002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2010 |
Last Update Date | 19/02/2010 |