Active NPI
Diane Mastroly
- Optician
- Wall Township, NJ
National Provider Identifier
1417022906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 3395
- Practice address
- 1933 State Route 35
Suite 120
Wall Township, NJ 07719-3502 - Phone
- (732) 449-9503
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 3395 | NJ | Primary |
Addresses
Primary practice location
1933 State Route 35
Suite 120
Wall Township, NJ 07719-3502
Mailing address
1933 RT.35
Suite 120
Wall, NJ 07719
Phone (732) 449-9503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3395 | NJ | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1417022906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1933 RT.35",
"address_2": "SUITE 120",
"city": "WALL",
"state": "NJ",
"postal_code": "07719",
"telephone_number": "732-449-9503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1933 STATE ROUTE 35",
"address_2": "SUITE 120",
"city": "WALL TOWNSHIP",
"state": "NJ",
"postal_code": "077193502",
"telephone_number": "732-449-9503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTROLY",
"first_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NJ",
"license": "3395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wall Township, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.