Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008945-1 | NY |
NPI | 1063932390 |
---|---|
Provider Name | Umair Haroon |
First Address | Woodhaven, NY 11421-1902 |
Second Address | Woodhaven, NY 11421-1902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2017 |
Last Update Date | 27/06/2017 |