Provider Demographics
NPI:1922250208
Name:CAROLYN LOBOCCHIARO, O.D.
Entity Type:Organization
Organization Name:CAROLYN LOBOCCHIARO, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBOCCHIARO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-367-2040
Mailing Address - Street 1:503 CANDLEWOOD COMMONS
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2172
Mailing Address - Country:US
Mailing Address - Phone:732-367-2040
Mailing Address - Fax:
Practice Address - Street 1:503 CANDLEWOOD COMMONS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2172
Practice Address - Country:US
Practice Address - Phone:732-367-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00543400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU66444Medicare UPIN