Provider Demographics
NPI:1851522700
Name:AMY A TRESKI OD & ASSOCIATES PC
Entity Type:Organization
Organization Name:AMY A TRESKI OD & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:TRESKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:609-799-9177
Mailing Address - Street 1:3371 US HIGHWAY 1
Mailing Address - Street 2:163 MERCER MALL
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-1303
Mailing Address - Country:US
Mailing Address - Phone:609-799-9177
Mailing Address - Fax:609-452-0758
Practice Address - Street 1:3371 US HIGHWAY 1
Practice Address - Street 2:163 MERCER MALL
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-1303
Practice Address - Country:US
Practice Address - Phone:609-799-9177
Practice Address - Fax:609-452-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00459600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ158287Medicare PIN
NJ155412Medicare PIN