Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | 5536217 | NY |
N | 156FC0801X | Contact Lens Fitter | 5536217 | NY |
N | 156FX1800X | Optician | C006861-1 | NY |
NPI | 1467575373 |
---|---|
Provider Name | Mrs. Dawn Patricia Young |
First Address | Trumansburg, NY 14886 |
Second Address | Ithaca, NY 14850-5255 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 08/07/2007 |