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General NPI Number Information
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NPI Number | 1134270788
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Entity Type | Organization
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Legal Business Name | SALLY HALIM, LLC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 802 DELSEA DR N
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City | GLASSBORO
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State | NJ
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Zip | 08028-1438
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Country | US
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Telephone | 856-582-5550
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Fax | 856-582-5550
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Provider Business Mailing Address
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Address Line | 802 DELSEA DR N
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City | GLASSBORO
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State | NJ
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Zip | 08028-1438
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Country | US
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Telephone | 856-582-5550
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Fax | 856-582-5550
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Authorized Official
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Title or Position | OPTOMETRIC PHYSICIAN
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Name | DR. SALLY HALIM
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Credential | O.D.
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Telephone | 856-582-5550
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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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