Provider Demographics
NPI:1306817465
Name:CONWAY, JANET M (OD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:M
Last Name:CONWAY
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 1:1025 HAINES MILL RD
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-4006
Mailing Address - Country:US
Mailing Address - Phone:732-977-6368
Mailing Address - Fax:
Practice Address - Street 1:5250 NEW JERSEY AVE
Practice Address - Street 2:
Practice Address - City:FORT DIX
Practice Address - State:NJ
Practice Address - Zip Code:08640-5017
Practice Address - Country:US
Practice Address - Phone:609-562-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00555400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist