Provider Demographics
NPI:1497832703
Name:MASLANSKY, EDWARD S (OD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:S
Last Name:MASLANSKY
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 1:2 APPLE FARM RD
Mailing Address - Street 2:MIDDLETOWN TOWNSHIP
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5094
Mailing Address - Country:US
Mailing Address - Phone:732-671-7451
Mailing Address - Fax:732-671-7216
Practice Address - Street 1:2 APPLE FARM RD
Practice Address - Street 2:MIDDLETOWN TOWNSHIP
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5094
Practice Address - Country:US
Practice Address - Phone:732-671-7451
Practice Address - Fax:732-671-7216
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00407901152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ212589OtherMEDICARE PTAN
NJ410007247OtherRAILROAD MEDICARE
NJ0694207Medicaid
NJ0694207Medicaid
NJT82491Medicare UPIN