NPIMap

Organization Active NPI

Mobile Vision LLC

  • Ophthalmology Physician
  • Freehold, NJ
National Provider Identifier
1003973595
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA07781000 Issued in NJ
Legal business name
MOBILE VISION LLC
Practice address
509 Stillwells Corner Road
Suite E5
Freehold, NJ 07728-2965
Phone
(732) 431-9333
Fax
(732) 431-3312
NPI assigned
Jan 3, 2007
Last updated
Dec 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eric Andrew Gershenbaum, MDNPI 1548227309
Title
LLC Member
Phone
(732) 431-9333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 005273 NJ
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 25MA07781000 NJ Primary

Addresses

Primary practice location

509 Stillwells Corner Road
Suite E5
Freehold, NJ 07728-2965

Mailing address

509 Stillwells Corner Road
Suite E5
Freehold, NJ 07728-2965
Phone (732) 431-9333

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1003973595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 STILLWELLS CORNER ROAD",
            "address_2": "SUITE E5",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282965",
            "telephone_number": "732-431-9333",
            "fax_number": "732-431-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 STILLWELLS CORNER ROAD",
            "address_2": "SUITE E5",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282965",
            "telephone_number": "732-431-9333",
            "fax_number": "732-431-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "GERSHENBAUM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "LLC MEMBER",
        "authorized_official_telephone_number": "732-431-9333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "005273",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA07781000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.