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NPI Code Detail

MEDICARE: DR. WILLIAM CHARLES FRUCHTMAN O.D.

MEDICARE:  DR. WILLIAM CHARLES FRUCHTMAN  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist27OA00514400NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447200241
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM CHARLES FRUCHTMAN O.D.
Provider Business Mailing Address
First Line : 196 PATERSON AVE
Second Line :
City : EAST RUTHERFORD
State : NJ
Zip : 07073-1841
Country : US
Telephone Number : 201-728-9222
Fax Number : 201-728-9229
Provider Business Practice Location Address
First Line : 196 PATERSON AVE
Second Line :
City : EAST RUTHERFORD
State : NJ
Zip : 07073-1841
Country : US
Telephone Number : 201-728-9222
Fax Number : 201-728-9229
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 02/05/2019

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