MEDICARE: DR. RUTH ANDREA SALKIN O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	270A00432100	NJ
2	152WP0200X	Pediatric Optometrist	270A00432100	NJ
3	152WV0400X	Vision Therapy Optometrist	270A00432100	NJ
4	152W00000X	Optometrist	270A00432100	NJ

General Provider Information

NPI Number	:	1851476881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH ANDREA SALKIN O.D.

Provider Business Mailing Address
First Line	:	422 PASCACK ROAD
Second Line	:
City	:	WASHINGTON TOWNSHIP
State	:	NJ
Zip	:	07676-4837
Country	:	US
Telephone Number	:	201-664-4477
Fax Number	:

Provider Business Practice Location Address
First Line	:	422 PASCACK ROAD
Second Line	:
City	:	WASHINGTON TOWNSHIP
State	:	NJ
Zip	:	07676-4837
Country	:	US
Telephone Number	:	201-664-4477
Fax Number	:	201-666-4290

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

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	02/09/2010

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