Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | C008931-1 | NY |
NPI | 1104339605 |
---|---|
Provider Name | Marian Considine |
First Address | Rochester, NY 14618-5646 |
Second Address | Rochester, NY 14618-5646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2017 |
Last Update Date | 07/11/2017 |