Healthcare Provider Details

I. General information

NPI: 1730023433
Provider Name (Legal Business Name): JEFFREY SONNENBLICK OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GARDEN STATE PLZ
PARAMUS NJ
07652-2417
US

IV. Provider business mailing address

1 GARDEN STATE PLZ
PARAMUS NJ
07652-2417
US

V. Phone/Fax

Practice location:
  • Phone: 201-712-0888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00741800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: