Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008977 | NY |
NPI | 1194225334 |
---|---|
Provider Name | Mrs. Allison C Ryan |
First Address | Troy, NY 12180-2451 |
Second Address | Troy, NY 12180-2451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2018 |
Last Update Date | 14/02/2018 |