Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008708-1 | NY |
NPI | 1043726755 |
---|---|
Provider Name | Mr. Richard L Rinaldi SR. |
First Address | Herkimer, NY 13350-1716 |
Second Address | Herkimer, NY 13350-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2017 |
Last Update Date | 18/12/2017 |