Provider Demographics
NPI:1003903717
Name:ANGLIM, JAMES JR (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:ANGLIM
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4321
Mailing Address - Country:US
Mailing Address - Phone:732-562-1804
Mailing Address - Fax:732-562-1741
Practice Address - Street 1:1303 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4321
Practice Address - Country:US
Practice Address - Phone:732-562-1804
Practice Address - Fax:732-562-1741
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00555800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist