=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003931668
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VIEW TWO, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 460 WOODBRIDGE CTR
-----------------------------------------------------
City | WOODBRIDGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07095-1305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-636-2112
-----------------------------------------------------
Fax | 732-636-2898
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 460 WOODBRIDGE CTR
-----------------------------------------------------
City | WOODBRIDGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07095-1305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-636-2112
-----------------------------------------------------
Fax | 732-636-2898
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. TERRI HABERMAN
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 732-636-2112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | NJ 27OA00482500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------