Healthcare Provider Details

I. General information

NPI: 1720136278
Provider Name (Legal Business Name): BARBARA ANNE DILLON OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 HOWARD BLVD. SUITE 18
MOUNT ARLINGTON NJ
07856-2314
US

IV. Provider business mailing address

180 HOWARD BLVD SUITE 18
MOUNT ARLINGTON NJ
07856-2318
US

V. Phone/Fax

Practice location:
  • Phone: 973-770-1380
  • Fax: 973-770-1384
Mailing address:
  • Phone: 973-770-1380
  • Fax: 973-770-1384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00518800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: