Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 001379 | CT |
NPI | 1073115044 |
---|---|
Provider Name | Margaret Texidor |
First Address | Cheshire, CT 06410-2548 |
Second Address | Cheshire, CT 06410-2548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2020 |
Last Update Date | 13/11/2020 |