Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 009341-1 | NY |
NPI | 1134549835 |
---|---|
Provider Name | Marcey A Denardo |
First Address | Silver Creek, NY 14136-1416 |
Second Address | Silver Creek, NY 14136-1416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2014 |
Last Update Date | 21/04/2014 |