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General NPI Number Information
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NPI Number | 1467724971
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Entity Type | Organization
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Legal Business Name | SHURMINSKY EYECARE LLC
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 01/30/2012
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Provider Practice Location Address
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Address Line | 161 N FRANKLIN TPKE SUITE 2A
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City | RAMSEY
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State | NJ
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Zip | 07446-1649
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Country | US
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Telephone | 201-825-8292
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Fax | 201-760-6496
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Provider Business Mailing Address
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Address Line | 161 N FRANKLIN TPKE SUITE 2A
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City | RAMSEY
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State | NJ
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Zip | 07446-1649
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Country | US
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Telephone | 201-825-8292
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Fax | 201-760-6496
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WALTER JOHN SHURMINSKY JR.
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Credential | OD
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Telephone | 201-825-8292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00467801
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License Number State | NJ
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