Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | NY |
NPI | 1194887406 |
---|---|
Provider Name | Mrs. Josephine Nonye Austin |
First Address | Forest Hills, NY 11375-2161 |
Second Address | Brooklyn, NY 11213-5552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 18/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02823545 | (05) | NY |