Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 006501 | NY |
NPI | 1043348352 |
---|---|
Provider Name | Patricia Morolli-Mione |
First Address | Lake Ronkonkoma, NY 11779-2320 |
Second Address | Riverhead, NY 11901-3146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 08/07/2007 |