Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist |
NPI | 1447312343 |
---|---|
Provider Name | Ms. Heather J Danz |
First Address | Montclair, NJ 07042-3582 |
Second Address | Montclair, NJ 07042-3582 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 08/07/2007 |