Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 006909 | NY |
NPI | 1114048709 |
---|---|
Provider Name | Mrs. Galina Orloff |
First Address | Bronx, NY 10467-3958 |
Second Address | Bronx, NY 10467-3958 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 19/09/2007 |