Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 7654 | NY |
NPI | 1912370453 |
---|---|
Provider Name | Mr. Ryan Mcnerney |
First Address | Buffalo, NY 14209-2331 |
Second Address | Buffalo, NY 14209-2331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2015 |
Last Update Date | 05/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7654 | ACVREP (01) |