Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 006472-1 | NY |
NPI | 1205279569 |
---|---|
Provider Name | Steven Hayes |
First Address | Glens Falls, NY 12801-2329 |
Second Address | Glens Falls, NY 12801-2329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2013 |
Last Update Date | 16/04/2013 |