Provider Demographics
NPI:1104092212
Name:CIPPARONE, KRISTEN (OD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:CIPPARONE
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 1:111 PREAKNESS DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-3603
Mailing Address - Country:US
Mailing Address - Phone:856-906-6079
Mailing Address - Fax:
Practice Address - Street 1:300 QUAKERBRIDGE MALL
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648
Practice Address - Country:US
Practice Address - Phone:609-936-2118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00559000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist