Provider Demographics
NPI:1508812181
Name:SHORT HILLS OPHTHALMOLOGY LLC
Entity Type:Organization
Organization Name:SHORT HILLS OPHTHALMOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:FARBOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-379-2544
Mailing Address - Street 1:777 PASSAIC AVE STE 485
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1800
Mailing Address - Country:US
Mailing Address - Phone:973-473-1515
Mailing Address - Fax:973-473-4811
Practice Address - Street 1:777 PASSAIC AVE STE 485
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1800
Practice Address - Country:US
Practice Address - Phone:973-473-1515
Practice Address - Fax:973-473-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4937840001Medicare NSC
NJ070265Medicare PIN
NJG69998Medicare UPIN