Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 3089 | NY |
NPI | 1205987534 |
---|---|
Provider Name | Mr. James G Harrity |
First Address | Derby, NY 14047-9689 |
Second Address | Derby, NY 14047-9689 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 09/07/2007 |