Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1845 | MA |
NPI | 1063965754 |
---|---|
Provider Name | Steven M Buffone |
First Address | Lancaster, MA 01523-3029 |
Second Address | Lancaster, MA 01523-3029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2016 |
Last Update Date | 28/07/2016 |