Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 74SC | OH |
NPI | 1013194133 |
---|---|
Provider Name | Mary Lou Nyitray |
First Address | Toledo, OH 43606-3022 |
Second Address | Toledo, OH 43606-3022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2008 |
Last Update Date | 31/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0170710 | (05) | OH |