Provider Demographics
NPI:1770650053
Name:LAIFER, NANCY JANE (OD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JANE
Last Name:LAIFER
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 1:39 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:NJ
Mailing Address - Zip Code:07620-0666
Mailing Address - Country:US
Mailing Address - Phone:201-767-4333
Mailing Address - Fax:201-767-6838
Practice Address - Street 1:210 KNICKERBOCKER RD
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626
Practice Address - Country:US
Practice Address - Phone:201-767-4333
Practice Address - Fax:201-767-6838
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ04000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0507650001OtherMEDICARE DMERC
NY00403154Medicaid
NJ521504Medicare ID - Type Unspecified
T81528Medicare UPIN