Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1306097514 |
---|---|
Provider Name | Mr. Robert W Soneira |
First Address | Bronx, NY 10468-3904 |
Second Address | Bronx, NY 10468-3904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2008 |
Last Update Date | 07/10/2008 |