Provider Demographics
NPI:1457420135
Name:CATARACT & LASER INSTITUTE P A
Entity Type:Organization
Organization Name:CATARACT & LASER INSTITUTE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEON
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUPPERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-367-0699
Mailing Address - Street 1:101 PROSPECT ST STE 102
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5003
Mailing Address - Country:US
Mailing Address - Phone:732-367-0699
Mailing Address - Fax:732-367-0937
Practice Address - Street 1:101 PROSPECT ST
Practice Address - Street 2:STE 102
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-367-0699
Practice Address - Fax:732-367-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ305436Medicare PIN