NPI | 1427351485 |
---|---|
Entity Type | Organization |
Authorized Contact | HOWARD RANDOLPH ELLISON Optician 917-291-2370 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: NY 008765) |
Additional Taxonomies | 305S00000X Point of Service (Licence: NY 0066601) |
Enumeration Date | 2010-12-14 |
Last Update Date | 2010-12-14 |