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Organization

TERRYLEE MAIMONE O.D, P.C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TERRYLEE MAIMONE O.D (OWNER)
(201) 703-2922
Entity
Organization

Contact information

Practice address
32-01 BROADWAY, FAIR LAWN, NJ 07410-4616
(201) 703-2922
(201) 791-6626
Mailing address
32-01 BROADWAY, FAIR LAWN, NJ 07410-4616
(201) 703-2922
(201) 791-6626

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00490500
NJ
152WV0400X
Vision Therapy Optometrist
27TO00040600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
177820
CHN
NJ
01
2099723
FIRST HEALTH
NJ
01
2319156
UNITED HEALTHCARE
NJ
01
2K3806
HEALTHNET
NJ
01
4495272
CIGNA
NJ
01
518967
AETNA
NJ
01
5452503
CCN
NJ
05
6018700
NJ
01
C228E1
EMPIRE BCBS
NJ
01
P2865102
OXFORD
NJ
Enumeration date
06/28/2007
Last updated
04/20/2008
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