Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 270OA00635500 | NJ |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 27OA00635500 | NJ |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 27OA635500 | NJ |
N | 152WV0400X | Optomitrist - Vision Therapist | 27OA00635500 | NJ |
NPI | 1104101492 |
---|---|
Provider Name | Gloria Ding |
First Address | Paramus, NJ 07652-5428 |
Second Address | Paramus, NJ 07652-5428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2011 |
Last Update Date | 18/10/2011 |