Provider Demographics
NPI:1346277548
Name:TEUSCHER, SCOTT (OD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:TEUSCHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 BELLWOOD PARK RD
Mailing Address - Street 2:
Mailing Address - City:ASBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08802-1209
Mailing Address - Country:US
Mailing Address - Phone:908-479-1438
Mailing Address - Fax:
Practice Address - Street 1:315 STATE HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1700
Practice Address - Country:US
Practice Address - Phone:908-788-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00469000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
764694C2WMedicare ID - Type Unspecified
U4898Medicare UPIN