Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | C5192 | NY |
Y | 156FX1800X | Optician | C5192 | NY |
NPI | 1033252291 |
---|---|
Provider Name | Mr. Samuel Thomas Pirozzolo |
First Address | Astoria, NY 11103-3828 |
Second Address | Astoria, NY 11103-3828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 20/01/2011 |