Provider Demographics
NPI:1497897953
Name:POPPLEWELL, DEBORAH ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:POPPLEWELL
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 1:40 BEY LEA RD STE B103
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2900
Mailing Address - Country:US
Mailing Address - Phone:732-349-1012
Mailing Address - Fax:732-349-1082
Practice Address - Street 1:40 BEY LEA RD STE B103
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2900
Practice Address - Country:US
Practice Address - Phone:732-349-1012
Practice Address - Fax:732-349-1082
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27TO00112200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU67860Medicare UPIN
NJ051437Medicare ID - Type UnspecifiedPRIVER ID NUMBER