Provider Demographics
NPI:1821188806
Name:ISRAEL R PLASNER ODPA
Entity Type:Organization
Organization Name:ISRAEL R PLASNER ODPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:PLASNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-752-6222
Mailing Address - Street 1:255 ROUTE 22 EAST
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812
Mailing Address - Country:US
Mailing Address - Phone:732-752-6222
Mailing Address - Fax:732-752-2030
Practice Address - Street 1:255 ROUTE 22 EAST
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812
Practice Address - Country:US
Practice Address - Phone:732-752-6222
Practice Address - Fax:732-752-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00341600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U288503Medicare UPIN