Provider Demographics
NPI:1275744930
Name:WILLIAM J PRINSKET OD PA
Entity Type:Organization
Organization Name:WILLIAM J PRINSKET OD PA
Other - Org Name:PRIMARY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PRINSKET
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-359-1210
Mailing Address - Street 1:284 US HIGHWAY 206
Mailing Address - Street 2:BUILDING E SUITE 8
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4624
Mailing Address - Country:US
Mailing Address - Phone:908-359-1210
Mailing Address - Fax:908-359-1821
Practice Address - Street 1:284 US HIGHWAY 206
Practice Address - Street 2:BUILDING E SUITE 8
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4624
Practice Address - Country:US
Practice Address - Phone:908-359-1210
Practice Address - Fax:908-359-1821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00378300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU26908Medicare UPIN