Healthcare Provider Details

I. General information

NPI: 1154662732
Provider Name (Legal Business Name): MICHAEL A. ORNSTEIN OD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 ROUTE 202-206
PLUCKEMIN NJ
07978-0409
US

IV. Provider business mailing address

318 ROUTE 202-206 PO BOX 409
PLUCKEMIN NJ
07978-0409
US

V. Phone/Fax

Practice location:
  • Phone: 908-781-2121
  • Fax: 908-781-7747
Mailing address:
  • Phone: 908-781-2121
  • Fax: 908-781-7747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number27OA00349400
License Number StateNJ

VIII. Authorized Official

Name: DR. MICHAEL A ORNSTEIN
Title or Position: PROVIDER/OWNER
Credential: OD
Phone: 908-781-2121