Provider Demographics
NPI:1275595241
Name:CENTER FOR VISUAL REHABILITATION, INC.
Entity Type:Organization
Organization Name:CENTER FOR VISUAL REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:PHIL
Authorized Official - Last Name:EINHORN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-681-2320
Mailing Address - Street 1:613 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2341
Mailing Address - Country:US
Mailing Address - Phone:732-681-2320
Mailing Address - Fax:732-280-2320
Practice Address - Street 1:613 10TH AVE
Practice Address - Street 2:
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-2341
Practice Address - Country:US
Practice Address - Phone:732-681-2320
Practice Address - Fax:732-280-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1135007Medicaid
NJ119257OtherAETNA
NJ1K8398OtherHEALTHNET
NJP822815OtherOXFORD
NJ119257OtherAETNA