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General NPI Number Information
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NPI Number | 1407881733
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Entity Type | Individual
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Provider Name | ANDREA S. WEBER O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1964 N OLDEN AVENUE EXT
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City | TRENTON
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State | NJ
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Zip | 08618-2110
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Country | US
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Telephone | 609-883-4407
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Fax |
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Provider Business Mailing Address
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Address Line | 145 YORKSHIRE CIR
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City | EWING
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State | NJ
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Zip | 08628-3253
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Country | US
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Telephone |
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Fax |
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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 | OA006039/TO001418
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License Number State | NJ
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