Provider Demographics
NPI:1710089008
Name:ANSPACH OF SUMMIT INC.
Entity Type:Organization
Organization Name:ANSPACH OF SUMMIT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ERBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-273-0379
Mailing Address - Street 1:22 BEECHWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:908-273-0379
Mailing Address - Fax:908-273-6533
Practice Address - Street 1:22 BEECHWOOD RD
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2511
Practice Address - Country:US
Practice Address - Phone:908-273-0379
Practice Address - Fax:908-273-6533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD1087156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0675040001Medicare ID - Type Unspecified