Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FX1201X | Optometric Assistant | ||
N | 156FX1202X | Optometric Technician | ||
Y | 156FX1800X | Optician |
NPI | 1063773471 |
---|---|
Provider Name | Mr. Asab Ramedani |
First Address | Washington, DC 20007-3310 |
Second Address | Washington, DC 20007-3310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2012 |
Last Update Date | 01/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | DC |