Healthcare Provider Details

I. General information

NPI: 1508003401
Provider Name (Legal Business Name): DONALD F. FELTER OPTICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 FRANKLIN AVE
WYCKOFF NJ
07481-1966
US

IV. Provider business mailing address

379 FRANKLIN AVE
WYCKOFF NJ
07481-1966
US

V. Phone/Fax

Practice location:
  • Phone: 201-891-1200
  • Fax: 201-891-4306
Mailing address:
  • Phone: 201-891-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number31TD00065100
License Number StateNJ

VIII. Authorized Official

Name: MR. DAVID A MARTIN
Title or Position: OWNER
Credential: OPTICIAN
Phone: 201-891-1200