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General NPI Number Information
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NPI Number | 1679743835
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Entity Type | Organization
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Legal Business Name | JILL SAXON OD LLC
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 301 MOUNT HOPE AVE
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City | ROCKAWAY
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State | NJ
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Zip | 07866-2130
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Country | US
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Telephone | 973-270-6270
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Fax |
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Provider Business Mailing Address
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Address Line | 37 VALLEY RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-2970
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Country | US
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Telephone | 973-270-6270
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JILL M SAXON
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Credential | O.D.
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Telephone | 973-270-6270
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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 | 27OA00608900
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License Number State | NJ
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