Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 005471 | NY |
NPI | 1235360579 |
---|---|
Provider Name | Mary E Whitcombe |
First Address | Utica, NY 13501-6240 |
Second Address | Utica, NY 13502-1461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2009 |
Last Update Date | 04/08/2009 |