Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 008752-1 | NY |
NPI | 1205342532 |
---|---|
Provider Name | Valerie Jean Foster |
First Address | New Hartford, NY 13413-6211 |
Second Address | New Hartford, NY 13413-6211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2017 |
Last Update Date | 22/12/2017 |