Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 004916-1 | NY |
NPI | 1003982919 |
---|---|
Provider Name | Mr. Paul Farber |
First Address | Scarsdale, NY 10583-3211 |
Second Address | Scarsdale, NY 10583-3211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 08/07/2007 |