Provider Demographics
NPI:1790907947
Name:THEODORE PEARLMAN MD PA
Entity Type:Organization
Organization Name:THEODORE PEARLMAN MD PA
Other - Org Name:CATARACT AND EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:F
Authorized Official - Last Name:PEARLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-625-7970
Mailing Address - Street 1:16 POCONO RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2901
Mailing Address - Country:US
Mailing Address - Phone:973-625-7970
Mailing Address - Fax:973-625-9650
Practice Address - Street 1:SUITE 301
Practice Address - Street 2:16 POCONO ROAD
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2901
Practice Address - Country:US
Practice Address - Phone:973-625-7970
Practice Address - Fax:973-625-9650
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THEODORE F PEARLMAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-03
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA027401174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ070543Medicare PIN
NJ0987720001Medicare NSC