Provider Demographics
NPI:1225392483
Name:FELDBAUM-SMITH, JONI (OD)
Entity Type:Individual
Prefix:DR
First Name:JONI
Middle Name:
Last Name:FELDBAUM-SMITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JONI
Other - Middle Name:
Other - Last Name:FELDBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:10 INDUSTRIAL WAY E
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3332
Mailing Address - Country:US
Mailing Address - Phone:732-542-0300
Mailing Address - Fax:
Practice Address - Street 1:10 INDUSTRIAL WAY E
Practice Address - Street 2:SUITE 102
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-3332
Practice Address - Country:US
Practice Address - Phone:732-542-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007832152W00000X
NJ27OA00640500152W00000X
NJ27OM00112100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP01324043Medicare PIN