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General NPI Number Information
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NPI Number | 1104836428
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Entity Type | Organization
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Legal Business Name | IB VISION
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 515 N WOOD AVE SUITE 202
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City | LINDEN
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State | NJ
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Zip | 07036-4173
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Country | US
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Telephone | 908-486-3333
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Fax | 908-486-7475
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Provider Business Mailing Address
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Address Line | 515 N WOOD AVE SUITE 202
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City | LINDEN
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State | NJ
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Zip | 07036-4173
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Country | US
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Telephone | 908-486-3333
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Fax | 908-486-7475
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MEGGAN CLAIR HEINZ
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Credential | O.D.
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Telephone | 908-486-3333
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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 | 27OA00597900
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License Number State | NJ
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