Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 27OA00555800 | NJ |
NPI | 1003903717 |
---|---|
Provider Name | Dr. James Anglim JR. |
First Address | Piscataway, NJ 08854-4321 |
Second Address | Piscataway, NJ 08854-4321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 08/07/2007 |