Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1687 | CT |
NPI | 1073867206 |
---|---|
Provider Name | Meaghan L Sanderson |
First Address | New Britain, CT 06051-1915 |
Second Address | New Britain, CT 06051-1915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2012 |
Last Update Date | 09/11/2012 |