MEDICARE: DR. LAUREN G RISPOLI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MA056220	NJ
2	207W00000X	Ophthalmology Physician	25MA5622000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003801259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN G RISPOLI MD

Provider Business Mailing Address
First Line	:	46 EAGLE ROCK AVE
Second Line	:
City	:	EAST HANOVER
State	:	NJ
Zip	:	07936-3104
Country	:	US
Telephone Number	:	973-560-1500
Fax Number	:	973-560-0419

Provider Business Practice Location Address
First Line	:	VERONA OPTICIANS
Second Line	:	573 BLOOMFIELD AVE
City	:	VERONA
State	:	NJ
Zip	:	07044-1818
Country	:	US
Telephone Number	:	973-239-4518
Fax Number	:	973-239-6210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	11/27/2024

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