Provider Demographics
NPI:1063408805
Name:HALIM, SALLY (OD)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:
Last Name:HALIM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 CENTER SQUARE RD
Mailing Address - Street 2:UNIT 107
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1863
Mailing Address - Country:US
Mailing Address - Phone:856-832-4950
Mailing Address - Fax:856-832-4951
Practice Address - Street 1:120 CENTER SQUARE RD
Practice Address - Street 2:UNIT 107
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1863
Practice Address - Country:US
Practice Address - Phone:856-832-4950
Practice Address - Fax:856-832-4951
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ27OA00588800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1388229OtherAETNA HMO
NJ20-5488615OtherHORIZON BLUE CROSS
NJ3K4694OtherHEALTHNET
NJHA1527974OtherOPTICHOICE BCBS
NJP27974OtherAMERIHEALTH ADMINISTRATOR
P3916732OtherOXFORD
NJ223294272OtherVISION SERVICE PLAN
NJ7427497OtherAETNA PPO
NJ20-54-88615OtherCARPENTER'S WELFARE FUND
NJ0065307Medicaid
2804063OtherUNITED HEALTH CARE
NJ7901OtherEYE MED
PA0000097476OtherOPERATING ENGINEERS
NJ19821OtherSPECTERA AMERICHOICE
NJ142-4137OtherCIGNA PPO
NJ2213488000OtherAMERIHEALTH
NJ2213488000OtherINDEPENDENCE BLUE CROSS
NJ2213488000OtherKEYSTONE EAST MEDICAL
NJ19821OtherSPECTERA AMERICHOICE
NJ0065307Medicaid