Individual
DR. TAEWHA CAROLYN MOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
225 BROAD AVE STE 206, PALISADES PARK, NJ 07650-1590
(201) 585-1337
(201) 585-2998
Mailing address
225 BROAD AVE STE 206, PALISADES PARK, NJ 07650-1590
(201) 585-1337
(201) 585-2998
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
270A00465400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5084601
—
NJ
Enumeration date
09/23/2006
Last updated
03/09/2017
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