Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 8110 | NY |
NPI | 1073636502 |
---|---|
Provider Name | Ms. Sheila Ann Harrison |
First Address | Plattsburgh, NY 12901-6196 |
Second Address | Plattsburgh, NY 12901-1755 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |