Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 005028-1 | NY |
NPI | 1023441037 |
---|---|
Provider Name | Raymond F Calhoon JR. |
First Address | Cheektowaga, NY 14227-1950 |
Second Address | Cheektowaga, NY 14227-1950 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2013 |
Last Update Date | 13/08/2013 |