Individual
SUSAN VALENZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DISPENSING OPTICIAN
Contact information
Practice address
148 FRANKLIN AVE, NUTLEY, NJ 07110-2925
(973) 667-0444
(973) 667-2353
Mailing address
148 FRANKLIN AVE, NUTLEY, NJ 07110-2925
(973) 667-0444
(973) 667-2353
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
31TD00091000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2903008
—
NJ
Enumeration date
05/08/2007
Last updated
08/31/2011
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