Provider Demographics
NPI:1255542254
Name:YOSSEF, ERIC O (OD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:O
Last Name:YOSSEF
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 EWING ST
Mailing Address - Street 2:SUITE C-15
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2757
Mailing Address - Country:US
Mailing Address - Phone:609-921-2300
Mailing Address - Fax:609-921-9137
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:SUITE C-15
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-921-2300
Practice Address - Fax:609-921-9137
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006770152WC0802X
NJ27OA00593900152W00000X
NJ27TO001322300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ175691V5WMedicare PIN