Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | C004002-1 | NY |
N | 156FX1100X | Ophthalmic | C004002-1 | NY |
NPI | 1710033881 |
---|---|
Provider Name | Mr. Jerry Steiner |
First Address | Riverhead, NY 11901-2802 |
Second Address | Riverhead, NY 11901-2802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 08/07/2007 |