Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 4521 | MA |
NPI | 1144346297 |
---|---|
Provider Name | Mrs. Geraldine Mays |
First Address | Taunton, MA 02780-3651 |
Second Address | Taunton, MA 02780-3651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1525905 | (05) | MA |