Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | COO5692 | NY |
N | 156FC0801X | Contact Lens Fitter | COO5692 | NY |
Y | 156FX1100X | Ophthalmic | COO5692 | NY |
N | 156FX1202X | Optometric Technician | COO5692 | NY |
NPI | 1699002345 |
---|---|
Provider Name | Mr. Anthony Frank Gaggi |
First Address | New York, NY 10003 |
Second Address | New York, NY 10003-8116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2009 |
Last Update Date | 19/11/2009 |