Provider Demographics
NPI:1134270788
Name:SALLY HALIM, LLC
Entity type:Organization
Organization Name:SALLY HALIM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-582-5550
Mailing Address - Street 1:802 DELSEA DR N
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1438
Mailing Address - Country:US
Mailing Address - Phone:856-582-5550
Mailing Address - Fax:856-582-5550
Practice Address - Street 1:802 DELSEA DR N
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1438
Practice Address - Country:US
Practice Address - Phone:856-582-5550
Practice Address - Fax:856-582-5550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00588800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1388229OtherAETNA HMO
NJ221-348-8000OtherKEYSTONE EAST MEDICAL
P3916732OtherOXFORD
NJ2804603OtherUNITED HEALTH CARE
NJ3K4694OtherHEALTHNET
NJ147-76-9650OtherNVA
NJ221-348-8000OtherAMERIHEALTH
NJ142-4137OtherCIGNA PPO
NJHA1527974 (H)OtherOPTICHOICE
NJNJ7901OtherEYEMED
NJ147-76-9650OtherOPERATING ENGINEERS
NJ7427497OtherAETNA PPO
NJ0065307Medicaid
NJ19821OtherSPECTERA
NJP27974OtherAMERIHEALTH ADMINISTRATOR
NJ221-348-8000OtherINDEPENDENCE BLUE CROSS
NJ53916OtherDAVIS
NJ2804603OtherUNITED HEALTH CARE
NJ0065307Medicaid