Provider Demographics
NPI:1730131418
Name:SCHOENER, EUGENE R (OD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:R
Last Name:SCHOENER
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 1:530 LAKEHURST ROAD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755
Mailing Address - Country:US
Mailing Address - Phone:732-341-4733
Mailing Address - Fax:732-341-2794
Practice Address - Street 1:530 LAKEHURST ROAD
Practice Address - Street 2:SUITE 206
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-341-4733
Practice Address - Fax:732-341-2794
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00542700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7029209Medicaid
NJ027381OtherMEDICARE GROUP #
NJ888585NAQOtherMEDICARE IND PROVIDER #
NJ7029209Medicaid