Provider Demographics
NPI:1225289812
Name:HERDMAN, WILLIAM C (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:HERDMAN
Suffix:
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 1:150 LAKESIDE BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:07850-1144
Mailing Address - Country:US
Mailing Address - Phone:973-770-9400
Mailing Address - Fax:
Practice Address - Street 1:150 LAKESIDE BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:LANDING
Practice Address - State:NJ
Practice Address - Zip Code:07850-1144
Practice Address - Country:US
Practice Address - Phone:973-770-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00494800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist