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General NPI Number Information
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NPI Number | 1063408805
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Entity Type | Individual
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Provider Name | SALLY HALIM O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2005
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 120 CENTER SQUARE RD UNIT 107
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City | SWEDESBORO
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State | NJ
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Zip | 08085-1863
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Country | US
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Telephone | 856-832-4950
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Fax | 856-832-4951
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Provider Business Mailing Address
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Address Line | 120 CENTER SQUARE RD UNIT 107
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City | SWEDESBORO
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State | NJ
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Zip | 08085-1863
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Country | US
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Telephone | 856-832-4950
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Fax | 856-832-4951
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00588800
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License Number State | NJ
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