Moon, Taewha Carolyn
Moon, Taewha Carolyn is an sole proprietor health care provider with primary practice located at 225 Broad Ave Ste 206 , Palisades Park NJ 07650-1590. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Moon, Taewha Carolyn can be contacted via phone (201) 585-1337.Contact Information
Primary practice address
225 Broad Ave Ste 206
Palisades Park NJ 07650-1590
Phone: (201) 585-1337
Fax: (201) 585-2998
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 270A00465400 | New Jersey |
Profile Details
| NPI number | 1972603637 |
|---|---|
| LBN Legal business name | Moon, Taewha Carolyn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 23rd, 2006 |
| Last updated | Mar 9th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972603637 | NPPES |
| New Jersey | MEDICAID | 5084601 |
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