Provider Demographics
NPI:1922362870
Name:ON, JAMIE LAM (OD)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LAM
Last Name:ON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 6423
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-0423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:LENSCRAFTERS AT MACY'S
Practice Address - Street 2:400 COMMONS WAY
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807
Practice Address - Country:US
Practice Address - Phone:908-218-1264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14405152W00000X
NJ27OA00651000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist