Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 04984 | NJ |
Y | 152W00000X | Optometrist | T005003-1 | NY |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | T005003-1 | NY |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 04984 | NJ |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | T005003-1 | NY |
NPI | 1285691253 |
---|---|
Provider Name | Dr. Naomi R Knoller |
First Address | Teaneck, NJ 07666-2056 |
Second Address | Hawthorne, NY 10532-1535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 18/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01644182 | (05) | NY |
U39324 | (02) | NY |