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General NPI Number Information
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NPI Number | 1154545994
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Entity Type | Organization
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Legal Business Name | BEVERLY C. THOMSON
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 10 CODINGTON PL
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City | SOMERVILLE
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State | NJ
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Zip | 08876-2408
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Country | US
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Telephone | 908-725-0144
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Fax | 908-722-6785
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Provider Business Mailing Address
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Address Line | 10 CODINGTON PL
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City | SOMERVILLE
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State | NJ
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Zip | 08876-2408
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Country | US
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Telephone | 908-725-0144
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Fax | 908-722-6785
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Authorized Official
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Title or Position | OWNER
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Name | DR. BEVERLY MILLER
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Credential | O.D.
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Telephone | 908-725-0144
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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 | 27OA00573100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00293200
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License Number State | NJ
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