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Individual

DR. NIVAN PHILLIPS GENDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
290 STATE ROUTE 18, EAST BRUNSWICK, NJ 08816-1995
(732) 387-1060
Mailing address
290 STATE ROUTE 18, EAST BRUNSWICK, NJ 08816-1995
(732) 387-1060

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00621300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27OA00621300
NJ STATE BOARD OF OPTOMETRY
NJ
Enumeration date
08/28/2009
Last updated
05/19/2016
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