Provider Demographics
NPI:1508685553
Name:NEINO, MARIA L (ABOC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:NEINO
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
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Mailing Address - Street 1:45555 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2388
Mailing Address - Country:US
Mailing Address - Phone:734-985-9426
Mailing Address - Fax:734-485-2048
Practice Address - Street 1:45555 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2388
Practice Address - Country:US
Practice Address - Phone:734-985-9426
Practice Address - Fax:734-485-2048
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI257898156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician