Provider Demographics
NPI:1083699516
Name:CONSIDINE, MAUREEN C (OD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:C
Last Name:CONSIDINE
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 1:71 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1855
Mailing Address - Country:US
Mailing Address - Phone:973-763-2203
Mailing Address - Fax:973-762-9449
Practice Address - Street 1:71 2ND ST
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1855
Practice Address - Country:US
Practice Address - Phone:973-763-2203
Practice Address - Fax:973-762-9449
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00420300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2055104Medicaid
U14024Medicare UPIN
NJ2055104Medicaid