Provider Demographics
NPI:1417169426
Name:ROBINSON, ERIC (OD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:ROBINSON
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 1:1688 ROUTE 22 E
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-6508
Mailing Address - Country:US
Mailing Address - Phone:908-322-5020
Mailing Address - Fax:908-322-1938
Practice Address - Street 1:1688 ROUTE 22 E
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-6508
Practice Address - Country:US
Practice Address - Phone:908-322-5020
Practice Address - Fax:908-322-1938
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00411100152W00000X
NJ27TO00020300152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ712108Medicare PIN