Healthcare Provider Details
I. General information
NPI: 1851372270
Provider Name (Legal Business Name): DR. HARVEY L. KERKER & DR. IVY H. SPEARS, OPTOMETRIC PHYSICIANS, L.L.P
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/11/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
40 BEY LEA RD BEY LEA COMMONS SUITE C 104
TOMS RIVER NJ
08753-2900
US
IV. Provider business mailing address
40 BEY LEA RD BEY LEA COMMONS SUITE C 104
TOMS RIVER NJ
08753-2900
US
V. Phone/Fax
- Phone: 732-349-2020
- Fax: 732-341-1652
- Phone: 732-349-2020
- Fax: 732-341-1652
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HARVEY
LEE
KERKER
Title or Position: OWNER/ DOCTOR
Credential: O.D.
Phone: 732-349-2020