Provider Demographics
NPI:1851581599
Name:PONE, DAVID A
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:PONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1931
Mailing Address - Country:US
Mailing Address - Phone:609-586-6633
Mailing Address - Fax:
Practice Address - Street 1:2303 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-1931
Practice Address - Country:US
Practice Address - Phone:609-586-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00132000156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1204820001Medicare PIN