Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 6899 | NY |
NPI | 1033341243 |
---|---|
Provider Name | Michael Maimran |
First Address | New York, NY 10028-2108 |
Second Address | New York, NY 10028-2108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2009 |
Last Update Date | 21/08/2009 |