Provider Demographics
NPI:1851476881
Name:SALKIN, RUTH ANDREA (OD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:ANDREA
Last Name:SALKIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 PASCACK ROAD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-4837
Mailing Address - Country:US
Mailing Address - Phone:201-664-4477
Mailing Address - Fax:
Practice Address - Street 1:422 PASCACK ROAD
Practice Address - Street 2:
Practice Address - City:WASHINGTON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07676-4837
Practice Address - Country:US
Practice Address - Phone:201-664-4477
Practice Address - Fax:201-666-4290
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00432100152WC0802X, 152WP0200X, 152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1154950001Medicare NSC
NJU26927Medicare UPIN
NJ521620Medicare PIN