MEDICARE: DR. ROBERT H CAMERON O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OA 02859	NJ

General Provider Information

NPI Number	:	1558309310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT H CAMERON O.D.

Provider Business Mailing Address
First Line	:	190 DAYTON ST
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-4408
Country	:	US
Telephone Number	:	201-652-1531
Fax Number	:	201-652-6436

Provider Business Practice Location Address
First Line	:	190 DAYTON ST
Second Line	:
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-4408
Country	:	US
Telephone Number	:	201-652-1531
Fax Number	:	201-652-6436

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	06/17/2008

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