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General NPI Number Information
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NPI Number | 1538544374
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Entity Type | Individual
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Provider Name | MATTHEW BUDESHEIM
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Gender | Male
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 07/22/2015
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Provider Practice Location Address
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Address Line | 154 STATE ROUTE 10 W
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City | EAST HANOVER
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State | NJ
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Zip | 07936
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Country | US
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Telephone | 973-887-0216
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Fax | 973-887-0289
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Provider Business Mailing Address
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Address Line | 154 STATE ROUTE 10 W
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City | EAST HANOVER
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State | NJ
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Zip | 07936
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Country | US
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Telephone | 973-887-0216
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Fax | 973-887-0289
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 31TD00377200
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License Number State | NJ
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