1467760793 NPI number — JOSEPH LAMMENS OD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467760793 NPI number — JOSEPH LAMMENS OD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOSEPH LAMMENS OD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467760793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WALMART VISION CENTER
Provider Second Line Business Mailing Address:
150 HARRISON AVE
Provider Business Mailing Address City Name:
KERNY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07032-2641
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-790-2909
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WALMART VISION CENTER
Provider Second Line Business Practice Location Address:
150 HARRISON AVE
Provider Business Practice Location Address City Name:
KEARNY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07032-5950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-955-0354
Provider Business Practice Location Address Fax Number:
201-955-0363
Provider Enumeration Date:
09/21/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LAMMENS
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
315-790-2909

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  27AO00606500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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