Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 155852 | PA |
NPI | 1194093492 |
---|---|
Provider Name | Francis G Gimbel JR. |
First Address | Plymouth Meeting, PA 19462-1027 |
Second Address | Plymouth Meeting, PA 19462-1027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 22/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
155852 | AMERICAN BOARD OF OPTICIANRY (01) | PA |