Provider Demographics
NPI:1356405153
Name:DALE STEIN AND ASSOCIATES, O.D.,P.C.
Entity type:Organization
Organization Name:DALE STEIN AND ASSOCIATES, O.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOLDSCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-384-0388
Mailing Address - Street 1:1750 CLEMENTS BRIDGE RD
Mailing Address - Street 2:2E5B DEPTFORD MALL
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-2010
Mailing Address - Country:US
Mailing Address - Phone:856-384-0388
Mailing Address - Fax:856-384-6405
Practice Address - Street 1:1750 CLEMENTS BRIDGE RD
Practice Address - Street 2:2E5B DEPTFORD MALL
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-2010
Practice Address - Country:US
Practice Address - Phone:856-384-0388
Practice Address - Fax:856-384-6405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00461700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDA623328Medicare ID - Type Unspecified