Doctor Name: | MR. AMJAD MAHMOUD HAYYAT |
NPI Number: | 1114042348 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OPTICIAN |
License Number: | 028-0000295 |
Business Practice Address: | 1 Washington St Middlebury, VT - 057531215 |
Business Phone Number: | 8023882165 |
Business Fax Number: | |
Mailing Address: | 3 Forbes Cir, MIDDLEBURY |
State: | VT |
Postal Code: | 057531128 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/20/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 028-0000295 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |