Healthcare Provider Details

I. General information

NPI: 1568386043
Provider Name (Legal Business Name): DORMESHIA WARD CLVT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 KNOLLCROFT RD BLDG 7
LYONS NJ
07939-5001
US

IV. Provider business mailing address

151 KNOLLCROFT RD BLDG 7
LYONS NJ
07939-5001
US

V. Phone/Fax

Practice location:
  • Phone: 973-616-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255R0406X
TaxonomyBlind Rehabilitation Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: