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General NPI Number Information
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NPI Number | 1861631830
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Entity Type | Organization
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Legal Business Name | THERESA C. FLEMING, O.D., P.C.
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 07/11/2013
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Provider Practice Location Address
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Address Line | 101 NORTH BROADWAY
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City | PENNSVILLE
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State | NJ
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Zip | 08070-1618
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Country | US
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Telephone | 856-678-2288
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Fax | 856-678-6466
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Provider Business Mailing Address
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Address Line | 101 NORTH BROADWAY
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City | PENNSVILLE
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State | NJ
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Zip | 08070-1618
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Country | US
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Telephone | 856-678-2288
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Fax | 856-678-6466
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Authorized Official
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Title or Position | OFFICER
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Name | DR. THERESA C FLEMING
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Credential | O.D.
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Telephone | 856-678-2288
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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 | NJ4130
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License Number State | NJ
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