Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | C0034861 | NY |
NPI | 1154472389 |
---|---|
Provider Name | Mr. Arthur O Laury |
First Address | Jamestown, NY 14701-2623 |
Second Address | Jamestown, NY 14701-2623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 22/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00602704 | (05) | NY |
50495 | DAVIS VISION (01) | NY |
NY0486 | EYEMED (01) | NY |
NY3486 | EYE MED (01) |