Provider Demographics
NPI:1104101492
Name:DING, GLORIA (OD)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:DING
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 1:275 FOREST AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5428
Mailing Address - Country:US
Mailing Address - Phone:201-986-0202
Mailing Address - Fax:
Practice Address - Street 1:275 FOREST AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5428
Practice Address - Country:US
Practice Address - Phone:201-986-0202
Practice Address - Fax:201-986-0977
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270OA00635500152W00000X
NJ27OA00635500152WC0802X, 152WV0400X
NJ27OA635500152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy