Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 006031 | NY |
NPI | 1023525516 |
---|---|
Provider Name | Mr. William James Marlow |
First Address | Niagara Falls, NY 14304-4704 |
Second Address | Niagara Falls, NY 14304-4704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2018 |
Last Update Date | 05/01/2018 |