Healthcare Provider Details

I. General information

NPI: 1659438307
Provider Name (Legal Business Name): STEVEN PINARD O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CHRIS GAUPP DR STE 101
GALLOWAY NJ
08205-4461
US

IV. Provider business mailing address

310 CHRIS GAUPP DR STE 101
GALLOWAY NJ
08205-4461
US

V. Phone/Fax

Practice location:
  • Phone: 609-485-2300
  • Fax: 609-485-2301
Mailing address:
  • Phone: 609-485-2300
  • Fax: 609-485-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number27OA00486200
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: