Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 003160 | AZ |
NPI | 1043827389 |
---|---|
Provider Name | Mrs. Sabina Krasnov |
First Address | Scottsdale, AZ 85258-2538 |
Second Address | Scottsdale, AZ 85258-2538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2020 |
Last Update Date | 30/09/2020 |