Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | C4708 | NY |
N | 156FX1800X | Optician | C4708 | NY |
NPI | 1396877379 |
---|---|
Provider Name | Mr. Kevin Patrick Whiting |
First Address | Binghamton, NY 13905-3107 |
Second Address | Binghamton, NY 13905-3107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2007 |