Provider Demographics
NPI:1346304631
Name:MOREIRA-HEINIG, JENNIFER MARY (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARY
Last Name:MOREIRA-HEINIG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:MOREIRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1000 STATE ROUTE 36
Mailing Address - Street 2:VISION CENTER
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-9323
Mailing Address - Country:US
Mailing Address - Phone:607-324-7142
Mailing Address - Fax:607-324-7965
Practice Address - Street 1:1000 STATE ROUTE 36
Practice Address - Street 2:VISION CENTER
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-9300
Practice Address - Country:US
Practice Address - Phone:607-324-7142
Practice Address - Fax:607-324-7965
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006197-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist