Provider Demographics
NPI:1619002607
Name:SINOWAY, TRACEY LYNN (OD)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:LYNN
Last Name:SINOWAY
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 1:385 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2306
Mailing Address - Country:US
Mailing Address - Phone:201-891-8237
Mailing Address - Fax:201-560-0573
Practice Address - Street 1:400 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-1347
Practice Address - Country:US
Practice Address - Phone:201-560-1000
Practice Address - Fax:201-560-0573
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00544500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist