Healthcare Provider Details

I. General information

NPI: 1124861505
Provider Name (Legal Business Name): ERICA ENARUSAI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 HADDON AVE
COLLINGSWOOD NJ
08108-1445
US

IV. Provider business mailing address

571 HADDON AVE
COLLINGSWOOD NJ
08108-1445
US

V. Phone/Fax

Practice location:
  • Phone: 856-858-3937
  • Fax: 856-425-2571
Mailing address:
  • Phone: 856-688-9093
  • Fax: 856-425-2571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG004165
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00740000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: