Provider Demographics
NPI:1376698845
Name:BRAFF, NEAL STUART (OD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:STUART
Last Name:BRAFF
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 1:2825 ROUTE18 SOUTH
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-0000
Mailing Address - Country:US
Mailing Address - Phone:732-955-0489
Mailing Address - Fax:732-679-2185
Practice Address - Street 1:2825 ROUTE18 SOUTH
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-0000
Practice Address - Country:US
Practice Address - Phone:732-955-0489
Practice Address - Fax:732-679-2185
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4175152W00000X
NJ27OA00417500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4679806Medicaid
NJ4679806Medicaid