Provider Demographics
NPI:1558309310
Name:CAMERON, ROBERT H (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:CAMERON
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 1:190 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4408
Mailing Address - Country:US
Mailing Address - Phone:201-652-1531
Mailing Address - Fax:201-652-6436
Practice Address - Street 1:190 DAYTON ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4408
Practice Address - Country:US
Practice Address - Phone:201-652-1531
Practice Address - Fax:201-652-6436
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA 02859152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU26810Medicare UPIN
NJ1155070001Medicare NSC
NJ521171Medicare PIN