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General NPI Number Information
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NPI Number | 1689656712
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Entity Type | Individual
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Provider Name | DAVID J LAX OD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 1700 WHITEHORSE HAMILTON SQUARE RD
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City | HAMILTON SQUARE
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State | NJ
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Zip | 08690-3536
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Country | US
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Telephone | 609-587-2020
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Fax | 609-588-9545
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Provider Business Mailing Address
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Address Line | 1700 WHITEHORSE HAMILTON SQUARE RD
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City | HAMILTON SQUARE
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State | NJ
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Zip | 08690-3536
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Country | US
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Telephone | 609-587-2020
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Fax | 609-588-9545
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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 | 270A00368900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 27T000071700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number | 27OA00368900
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License Number State | NJ
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