Provider Demographics
NPI:1174756894
Name:ASHLEY WEINER NOCHOMSON, O.D., L.L.C.
Entity type:Organization
Organization Name:ASHLEY WEINER NOCHOMSON, O.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:NOCHOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-806-3964
Mailing Address - Street 1:9365 SAVANNAH ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6986
Mailing Address - Country:US
Mailing Address - Phone:954-806-3964
Mailing Address - Fax:
Practice Address - Street 1:6266 S CONGRESS AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-2375
Practice Address - Country:US
Practice Address - Phone:561-966-9000
Practice Address - Fax:561-966-3264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4044152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty