Provider Demographics
NPI:1396381869
Name:ROBERTSHAW, ERIC M (HIS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:ROBERTSHAW
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 5TH AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5446
Mailing Address - Country:US
Mailing Address - Phone:732-207-5259
Mailing Address - Fax:
Practice Address - Street 1:730 JAMAICA BLVD STE 12
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-3758
Practice Address - Country:US
Practice Address - Phone:732-207-5259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist