Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 006337-1 | NY |
NPI | 1134354160 |
---|---|
Provider Name | Ms. Mary Elizabeth Wainwright |
First Address | Saratoga Spgs, NY 12866-9452 |
Second Address | Saratoga Spgs, NY 12866-9452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2009 |
Last Update Date | 19/05/2009 |