Healthcare Provider Details

I. General information

NPI: 1154248714
Provider Name (Legal Business Name): NAELA NAASAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 RIVER RD STE 210
EDGEWATER NJ
07020-1075
US

IV. Provider business mailing address

95 ANDERSON ST APT 447
HACKENSACK NJ
07601-0017
US

V. Phone/Fax

Practice location:
  • Phone: 609-576-4977
  • Fax:
Mailing address:
  • Phone: 609-576-4977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00744300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: