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General NPI Number Information
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NPI Number | 1881720910
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Entity Type | Organization
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Legal Business Name | ROBERT FOERSTER OPTICIAN, INC.
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Dates
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Enumeration Date | 02/25/2007
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 2327 NEW RD SUITE # 103
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1433
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Country | US
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Telephone | 609-641-5747
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Fax | 609-641-3990
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Provider Business Mailing Address
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Address Line | 201 TILTON RD STORE 16
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1247
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Country | US
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Telephone | 609-641-5747
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Fax | 609-641-3990
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GLENN ANDREW FOERSTER
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Credential | OPTICIAN
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Telephone | 609-641-5747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 31TD00146500
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License Number State | NJ
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