Doctor Name: | MR. MOHANNAD ZINDAKI |
NPI Number: | 1538514377 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.D.O |
License Number: | 31TD00378400 |
Business Practice Address: | 47 Layton Rd Sussex, NJ - 074611807 |
Business Phone Number: | 9732724166 |
Business Fax Number: | |
Mailing Address: | 47 Layton Rd, SUSSEX |
State: | NJ |
Postal Code: | 074611807 |
Phone Number: | 9732724166 |
Fax Number: | |
NPI Enumeration Date: | 04/29/2016 |
NPI Last Update Date: | 04/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 31TD00378400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |