Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008460 | NY |
NPI | 1093351694 |
---|---|
Provider Name | Miss Valentina Lashchuk |
First Address | Rome, NY 13440-1759 |
Second Address | Rome, NY 13440-1759 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2019 |
Last Update Date | 19/11/2019 |