Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1235427733 |
---|---|
Provider Name | Mrs. Sue Hosseini |
First Address | Hyattsville, MD 20783-4606 |
Second Address | Hyattsville, MD 20783-4606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2011 |
Last Update Date | 18/07/2011 |