Provider Demographics
NPI:1649211327
Name:VERNAMONTI, LAWRENCE FRANK (OD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:FRANK
Last Name:VERNAMONTI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 STOKES RD
Mailing Address - Street 2:SUITE B4
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2904
Mailing Address - Country:US
Mailing Address - Phone:609-654-6775
Mailing Address - Fax:
Practice Address - Street 1:520 STOKES RD
Practice Address - Street 2:SUITE B4
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2904
Practice Address - Country:US
Practice Address - Phone:609-654-6775
Practice Address - Fax:609-654-5889
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00373800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1005298OtherCIGNA
222444019OtherVSP
16291OtherAETNA
NJNJ3738OtherEYEMED
2224440190OtherHORIZON BCBS
2414691000OtherAMERIHEALTH
06111OtherOXFORD HEALTH
222444019OtherVSP
NJU26893Medicare UPIN