Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | 2962 | NY |
Y | 156FX1100X | Ophthalmic | 2962 | NY |
NPI | 1902990021 |
---|---|
Provider Name | Mr. Frank L. Herron |
First Address | Rochester, NY 14618-2410 |
Second Address | Rochester, NY 14618-2410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 22/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00507108 | (05) | NY |