Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 4330 | NY |
NPI | 1073679155 |
---|---|
Provider Name | Mr. Raymond Carl Porzio |
First Address | Mount Sinai, NY 11766-2020 |
Second Address | Mount Sinai, NY 11766-2020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2006 |
Last Update Date | 08/07/2007 |