Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008524 | NY |
NPI | 1194482463 |
---|---|
Provider Name | Maxine J Sanchez |
First Address | Woonsocket, RI 02895 |
Second Address | New Rochelle, NY 10801-5714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2021 |
Last Update Date | 22/11/2021 |