Provider Demographics
NPI:1417060849
Name:MCCURDY, PAULA ANN (OD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:ANN
Last Name:MCCURDY
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 1:2222 DELSEA DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLINVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08322-2523
Mailing Address - Country:US
Mailing Address - Phone:856-694-4475
Mailing Address - Fax:
Practice Address - Street 1:2222 DELSEA DR
Practice Address - Street 2:
Practice Address - City:FRANKLINVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08322-2523
Practice Address - Country:US
Practice Address - Phone:856-694-4475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00537900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6830200Medicaid
NJ560681OtherAETNA HMO
NJU55433Medicare UPIN
NJ560681OtherAETNA HMO