Provider Demographics
NPI:1770537060
Name:ROBERTS, ESTELLE JOANNA (OD)
Entity type:Individual
Prefix:DR
First Name:ESTELLE
Middle Name:JOANNA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-2715
Mailing Address - Country:US
Mailing Address - Phone:908-361-9891
Mailing Address - Fax:
Practice Address - Street 1:575 ROUTE 28
Practice Address - Street 2:SUITE 201A
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1354
Practice Address - Country:US
Practice Address - Phone:908-725-1772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00591000152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0132110Medicaid
NJ0132110Medicaid
NJU98774Medicare UPIN