Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | ||
Y | 156FX1800X | Optician |
NPI | 1912394974 |
---|---|
Provider Name | Kimberly Joy Camesi |
First Address | Pittsburgh, PA 15210-3677 |
Second Address | Pittsburgh, PA 15210-3677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2015 |
Last Update Date | 04/11/2015 |