Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 006312 | NY |
NPI | 1144419888 |
---|---|
Provider Name | Mrs. Terry Fehr |
First Address | Williamsville, NY 14221-4641 |
Second Address | Williamsville, NY 14221-4641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 18/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01946203 | (05) | NY |