Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 31TD00129800 | NJ |
NPI | 1164596581 |
---|---|
Provider Name | Mr. Lester Frankel |
First Address | Green Brook, NJ 08812-2200 |
Second Address | Green Brook, NJ 08812-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 09/07/2007 |