Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008502 | NY |
NPI | 1023068913 |
---|---|
Provider Name | Mr. Vladimir Bash |
First Address | College Point, NY 11356-2001 |
Second Address | College Point, NY 11356-2001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02334912 | (05) | NY |
15416 | SPECTERA (01) | NY |
330771 | NVA (01) | NY |
49779 | DAVIS VISION (01) | NY |
973N | NATIONAL OPTICAL SERVICES (01) | NY |
NY4302 | EYEMED (01) | NY |