Individual
WALTER DONACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6110 BERGENLINE AVE, WEST NEW YORK, NJ 07093-1568
(201) 861-1144
(201) 868-3577
Mailing address
17 SPARROW LN, WOODBURY, NY 11797-3206
(516) 528-3695
(516) 224-0991
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OA-004538
NJ
152W00000X
Optometrist
TUV-004396
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0515205
—
NJ
Enumeration date
01/27/2007
Last updated
02/22/2011
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