Provider Demographics
NPI:1831875848
Name:BOODY, LINDSEY CHRISTINE (OD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:CHRISTINE
Last Name:BOODY
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 1:295 FERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-3443
Mailing Address - Country:US
Mailing Address - Phone:973-589-8008
Mailing Address - Fax:
Practice Address - Street 1:295 FERRY ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-3443
Practice Address - Country:US
Practice Address - Phone:973-589-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00199200152W00000X
NYTRO009795152W00000X
NJ27OA00731700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist