Provider Demographics
NPI:1083949242
Name:HAMMONTON EYECARE LLC
Entity Type:Organization
Organization Name:HAMMONTON EYECARE LLC
Other - Org Name:HAMMONTON FAMILY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KAISTHA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:609-567-0997
Mailing Address - Street 1:120 S WHITE HORSE PIKE # B2
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1804
Mailing Address - Country:US
Mailing Address - Phone:609-567-0997
Mailing Address - Fax:
Practice Address - Street 1:120 S WHITE HORSE PIKE # B2
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1804
Practice Address - Country:US
Practice Address - Phone:609-567-0997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00591800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ178793Medicare PIN