Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | MA5286 | MA |
NPI | 1134320278 |
---|---|
Provider Name | Sylvester Reed Murphy JR. |
First Address | Boston, MA 02110-1111 |
Second Address | Boston, MA 02110-1111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 08/07/2007 |