Individual provider Active NPI

Doris Allison Sacks Wilner, OD

  • Optometrist
  • Trenton, NJ
National Provider Identifier
1992924682
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
270A00287700 Issued in NJ
Practice address
1901 North Olden Ave
Suite 27a
Trenton, NJ 08618
Phone
(609) 883-8989
Fax
(609) 883-1373
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 270A00287700 NJ Primary
Optometrist 152W00000X 27T000046100 NJ

Addresses

Primary practice location

1901 North Olden Ave
Suite 27a
Trenton, NJ 08618

Mailing address

1901 North Olden Ave
Suite 27a
Trenton, NJ 08618
Phone (609) 883-8989

Other identifiers 1

IdentifierTypeStateIssuer
2570807MedicaidNJ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
27T000046100NJMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992924682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 NORTH OLDEN AVE",
            "address_2": "SUITE 27A",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08618",
            "telephone_number": "609-883-8989",
            "fax_number": "609-883-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 NORTH OLDEN AVE",
            "address_2": "SUITE 27A",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08618",
            "telephone_number": "609-883-8989",
            "fax_number": "609-883-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKS WILNER",
        "first_name": "DORIS",
        "middle_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00287700",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27T000046100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2570807",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.