Provider Demographics
NPI:1720136278
Name:DILLON, BARBARA ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:ANNE
Last Name:DILLON
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 1:180 HOWARD BLVD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:MOUNT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-2318
Mailing Address - Country:US
Mailing Address - Phone:973-770-1380
Mailing Address - Fax:973-770-1384
Practice Address - Street 1:180 HOWARD BLVD. SUITE 18
Practice Address - Street 2:
Practice Address - City:MOUNT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-2314
Practice Address - Country:US
Practice Address - Phone:973-770-1380
Practice Address - Fax:973-770-1384
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00518800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223387132OtherEIN
NJ223387132OtherEIN