Provider Demographics
NPI:1659438307
Name:PINARD, STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:PINARD
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 1:310 CHRIS GAUPP DR STE 101
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4461
Mailing Address - Country:US
Mailing Address - Phone:609-485-2300
Mailing Address - Fax:609-485-2301
Practice Address - Street 1:310 CHRIS GAUPP DR STE 101
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4461
Practice Address - Country:US
Practice Address - Phone:609-485-2300
Practice Address - Fax:609-485-2301
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00486200152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJUO1972Medicare UPIN
NJ608172AN4Medicare ID - Type Unspecified