Provider Demographics
NPI:1477000586
Name:NEIHEISER, BERNADETTE (OD)
Entity Type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:
Last Name:NEIHEISER
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 1:10 SCHALKS CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-1612
Mailing Address - Country:US
Mailing Address - Phone:609-275-8989
Mailing Address - Fax:
Practice Address - Street 1:10 SCHALKS CROSSING RD
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1612
Practice Address - Country:US
Practice Address - Phone:609-275-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00515700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist