Provider Demographics
NPI:1912938523
Name:WESTWOOD OPTHALMOLOGY ASSOCIATES PA
Entity Type:Organization
Organization Name:WESTWOOD OPTHALMOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:KAIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-666-4014
Mailing Address - Street 1:PO BOX 698
Mailing Address - Street 2:300 FAIRVIEW AVENUE
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:201-666-4014
Mailing Address - Fax:601-666-4754
Practice Address - Street 1:300 FAIRVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-666-4014
Practice Address - Fax:201-666-4754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0705160001OtherRR MEDICARE
NJ2819601Medicaid
NJ2819601Medicaid
0705160001Medicare NSC
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