Provider Demographics
NPI:1467434407
Name:KERKER, HARVEY LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:LEE
Last Name:KERKER
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 1:40 BEY LEA RD
Mailing Address - Street 2:BEY LEA COMMONS SUITE C 104
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2900
Mailing Address - Country:US
Mailing Address - Phone:732-349-2020
Mailing Address - Fax:732-341-1652
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:BEY LEA COMMONS SUITE C 104
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2900
Practice Address - Country:US
Practice Address - Phone:732-349-2020
Practice Address - Fax:732-341-1652
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00418600152W00000X, 152WC0802X, 152WP0200X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Not Answered152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Not Answered152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01000481400OtherAMERICHOICE ID NUMBER
NJ150994OtherUNITED HEALTHCARE
NJ4377668OtherAETNA (NON-HMO)
NJ0055395Medicaid
NJG3410217OtherOXFORD GROUP ID NUNBER
NJ2K6818OtherHEALTHNET IND PROV ID NUM
NJ305803OtherUS FAMILY HEALTH PLAN
NJ2341813000OtherAMERIHEALTH
NJP2906781OtherOXFORD IND PROV ID NUMBER
NJ2093308Medicaid
NJ3607447OtherAETNA (HMO)
NJ24109OtherSPECTERA GROUP ID NUMBER
NJ965242OtherCIGNA PROV ID NUMBER
NJP2906781OtherOXFORD IND PROV ID NUMBER
NJ24109OtherSPECTERA GROUP ID NUMBER
NJ521417TXYMedicare ID - Type UnspecifiedRENDERING NUNMBER