Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 006587-1 | NY |
NPI | 1235278045 |
---|---|
Provider Name | Mrs. Ora Glass |
First Address | New Hyde Park, NY 11040-2028 |
Second Address | New Hyde Park, NY 11040-2028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 19/02/2008 |