Provider Demographics
NPI:1669736799
Name:HERMANN, NADINE F (OD)
Entity type:Individual
Prefix:DR
First Name:NADINE
Middle Name:F
Last Name:HERMANN
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 1:5 W MINGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-2413
Mailing Address - Country:US
Mailing Address - Phone:908-642-0366
Mailing Address - Fax:
Practice Address - Street 1:314 E MAIN ST STE 302
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7181
Practice Address - Country:US
Practice Address - Phone:302-292-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-04
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00106700152W00000X
NYTUV007830-1152W00000X
PAOEG002601152W00000X
NJ27OA00639600152W00000X
DEI3-001426152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist