1497969729 NPI number — GREGORY JOHN HUNTER OPHTHALMIC DISPENSER

Table of content: GREGORY JOHN HUNTER OPHTHALMIC DISPENSER (NPI 1497969729)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497969729 NPI number — GREGORY JOHN HUNTER OPHTHALMIC DISPENSER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNTER
Provider First Name:
GREGORY
Provider Middle Name:
JOHN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OPHTHALMIC DISPENSER
Provider Gender Code:
M

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:
1497969729
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 LITTLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRANCHVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07826-4400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-702-2340
Provider Business Mailing Address Fax Number:
973-702-2340

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
156 STATE HIGHWAY 10 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST HANOVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-560-4140
Provider Business Practice Location Address Fax Number:
973-884-3566
Provider Enumeration Date:
05/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , with the licence number:  31TD00100800 , 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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