Healthcare Provider Details

I. General information

NPI: 1992990477
Provider Name (Legal Business Name): YEKATERINA SHTEYN, OD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 06/30/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 COLUMBIA TURNPIKE COHEN'S FASHION OPTICAL
FLORHAM PARK NJ
07932
US

IV. Provider business mailing address

176 COLUMBIA TURNPIKE COHEN 'S FASHION OPTICAL
FLORHAM PARK NJ
07932
US

V. Phone/Fax

Practice location:
  • Phone: 973-994-1444
  • Fax: 973-994-2333
Mailing address:
  • Phone: 973-994-1444
  • Fax: 973-994-2333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number27OA00578100
License Number StateNJ

VIII. Authorized Official

Name: YEKATERINA SHTEYN
Title or Position: PRESIDENT
Credential: OD
Phone: 973-580-0464