Provider Demographics
NPI:1275773160
Name:DENLOW, REBECCA SUSAN (OD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SUSAN
Last Name:DENLOW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WILLOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1247
Mailing Address - Country:US
Mailing Address - Phone:732-951-9555
Mailing Address - Fax:
Practice Address - Street 1:2451 ROUTE 1 SOUTH
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:732-940-0678
Practice Address - Fax:732-940-0416
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00545901152W00000X
NJ27TO00083901152W00000X
NJ27OA00545900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU58498Medicare UPIN