Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008340 | NY |
NPI | 1073823597 |
---|---|
Provider Name | Mr. Drew Alan Washton |
First Address | New Hyde Park, NY 11040-1532 |
Second Address | New Hyde Park, NY 11040-1532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2010 |
Last Update Date | 18/10/2010 |