Provider Demographics
NPI:1619014297
Name:CONFORTI, WILLIAM (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:CONFORTI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 TENNENT RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3162
Mailing Address - Country:US
Mailing Address - Phone:732-536-0664
Mailing Address - Fax:732-536-2314
Practice Address - Street 1:700 TENNENT RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3162
Practice Address - Country:US
Practice Address - Phone:732-536-0664
Practice Address - Fax:732-536-2314
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00462100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ34740OtherDAVIS VISION
NJ0040551OtherUS HEALTHCARE
NJ311206OtherNVA
NJ6500867OtherG.H.I.
NJ02048OtherSPECTERA
NJ6097901Medicaid
NJ7325360664OtherVSP
NJKGOtherGVS
NJNY4568OtherEYEMED
NJNY4568OtherEYEMED