Provider Demographics
NPI:1083700249
Name:KUO, LINDA I (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:I
Last Name:KUO
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2 ETHEL ROAD
Mailing Address - Street 2:SUITE 203B
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2839
Mailing Address - Country:US
Mailing Address - Phone:732-410-7880
Mailing Address - Fax:732-410-7878
Practice Address - Street 1:2 ETHEL RD
Practice Address - Street 2:SUITE 203B INFINITY EYE CENTER
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2839
Practice Address - Country:US
Practice Address - Phone:732-410-7880
Practice Address - Fax:732-410-7878
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2015-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ270A00588400152W00000X
NJ27OM00084800152WC0802X
NJ27OA00588400152WP0200X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ079393Medicare PIN
NJU99908Medicare UPIN