Provider Demographics
NPI:1760589980
Name:BRANCHBURG EYE PHYSICIANS INC.
Entity Type:Organization
Organization Name:BRANCHBURG EYE PHYSICIANS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOHMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-526-5424
Mailing Address - Street 1:3461 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-6021
Mailing Address - Country:US
Mailing Address - Phone:908-526-5424
Mailing Address - Fax:908-707-8054
Practice Address - Street 1:3461 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-6021
Practice Address - Country:US
Practice Address - Phone:908-526-5424
Practice Address - Fax:908-707-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0256960207W00000X
207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1907301Medicaid