Neil Boderman PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000515 Issued in PA

Legal business name

NEIL BODERMAN PC

Practice address

3131 College Heights Blvd
Suite 300
Allentown, PA 18104-4858

Phone

(610) 435-9888

Fax

(610) 435-7809

NPI assigned

Nov 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Neil Boderman, OD

Title

President

Phone

(610) 435-9888

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1437223591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "SUITE 300",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044858",
            "telephone_number": "610-435-9888",
            "fax_number": "610-435-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "SUITE 300",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044858",
            "telephone_number": "610-435-9888",
            "fax_number": "610-435-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL BODERMAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "BODERMAN",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-435-9888",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.