Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | C003354 | NY |
NPI | 1154880227 |
---|---|
Provider Name | Ute Huber |
First Address | Vestal, NY 13850-2001 |
Second Address | Vestal, NY 13850-2001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2019 |
Last Update Date | 18/03/2019 |