Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 010199-1 | NY |
NPI | 1073071890 |
---|---|
Provider Name | Ms. Sanskrati Sharma |
First Address | Jackson Heights, NY 11372-7918 |
Second Address | Jackson Heights, NY 11372-7918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2019 |
Last Update Date | 10/10/2019 |