Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 5585 | NY |
NPI | 1023172442 |
---|---|
Provider Name | Joseph A Bilardi |
First Address | Staten Island, NY 10312-1809 |
Second Address | Staten Island, NY 10312-6527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |