Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1438 | MA |
NPI | 1124208475 |
---|---|
Provider Name | Mr. Joseph J Kobierecki |
First Address | Milford, MA 01757-0398 |
Second Address | Milford, MA 01757-3272 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2007 |
Last Update Date | 04/11/2007 |