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General NPI Number Information
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NPI Number | 1831354695
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Entity Type | Organization
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Legal Business Name | GLENN A. NEUFELD, OD, LLC
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Dates
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Enumeration Date | 07/22/2008
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 4 MAIN ST
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City | SPARTA
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State | NJ
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Zip | 07871-1900
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Country | US
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Telephone | 973-726-9679
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Fax | 973-726-9606
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Provider Business Mailing Address
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Address Line | 4 MAIN ST
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City | SPARTA
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State | NJ
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Zip | 07871-1900
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Country | US
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Telephone | 973-726-9679
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Fax | 973-726-9606
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Authorized Official
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Title or Position | OWNER
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Name | DR. GLENN A NEUFELD
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Credential | O.D.
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Telephone | 973-726-9679
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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 | 27OA00495100
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License Number State | NJ
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