Provider Demographics
NPI:1275973513
Name:JASANI, AMY VINOD (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:VINOD
Last Name:JASANI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2141 ROUTE 38 APT 1008
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-4215
Mailing Address - Country:US
Mailing Address - Phone:973-807-2616
Mailing Address - Fax:
Practice Address - Street 1:131 MADISON AVE STE 130
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7360
Practice Address - Country:US
Practice Address - Phone:973-267-1113
Practice Address - Fax:973-267-0719
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007980152W00000X
NJ27OA00652300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist