Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | 31TD00077300 | NJ |
N | 156FX1700X | Ocularist | 31TD00077300 | NJ |
Y | 156FX1800X | Optician | 31 TD00077300 | NJ |
NPI | 1619161601 |
---|---|
Provider Name | William H. Freund |
First Address | Linwood, NJ 08221-2167 |
Second Address | Linwood, NJ 08221-2167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2007 |
Last Update Date | 01/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0126365 | (05) | NJ |