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General NPI Number Information
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NPI Number | 1184926974
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Entity Type | Organization
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Legal Business Name | ROBERT R VANDERYAJT OD PC
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | PLAZA 23 225 ROUTE 23
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City | HAMBURG
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State | NJ
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Zip | 07419-1700
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Country | US
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Telephone | 973-823-0300
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Fax | 973-823-0038
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Provider Business Mailing Address
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Address Line | PLAZA 23 225 ROUTE 23
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City | HAMBURG
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State | NJ
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Zip | 07419-1700
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Country | US
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Telephone | 973-823-0300
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Fax | 973-823-0038
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT R VANDERYAJT
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Credential | OD
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Telephone | 973-823-0300
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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 | 27OA00441400
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License Number State | NJ
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