Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | D1422 | NJ |
NPI | 1225167935 |
---|---|
Provider Name | Stanley William Sochocky |
First Address | Ocean City, NJ 08226 |
Second Address | Ocean City, NJ 08226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5070406 | (05) | NJ |