Provider Demographics
NPI:1689640252
Name:RUMMEL, ERROL (OD)
Entity Type:Individual
Prefix:DR
First Name:ERROL
Middle Name:
Last Name:RUMMEL
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 1:2206 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2251
Mailing Address - Country:US
Mailing Address - Phone:732-364-4111
Mailing Address - Fax:732-901-0314
Practice Address - Street 1:2206 W COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2251
Practice Address - Country:US
Practice Address - Phone:732-364-4111
Practice Address - Fax:732-901-0314
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00275200152W00000X, 152WL0500X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223767279OtherTIN
NJ223767279OtherTIN
NJU23989Medicare UPIN