Kelly Marie Ludden-Liauw, O.D.

Key facts

NPI

1124011200

Entity type

Individual (NPI type 1)

Primary specialty

Optometrist 152W00000X

License

27OA00679900 (NJ)

Practice address

70 The Promenade
Edgewater, NJ 07020-2127

Phone

(201) 945-5487

NPI assigned

Aug 24, 2005

Sex

Female

Sole proprietor

No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Promenade Eye Care, P.a. Optometrist · Pompton Plains, NJ · NPI 1225283948
  NPD (past) OPTOMETRIST
• Luxottica of America Inc Eyewear Supplier · Kansas City, MO · NPI 1497412522
  NPD (past)
• Robert Friedman MD PC Specialist · New York, NY · NPI 1356419956
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 2, 2019.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1124011200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 THE PROMENADE",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070202127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 THE PROMENADE",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070202127",
            "telephone_number": "201-945-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDDEN-LIAUW",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006690",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00679900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, NJ

• Wei Wei Li, MD
• Daisy H Lignelli
• Tzu Yu Liu
• Adrian Lorenzo
• Lucia Alvarez, MD LLC
• Hazel Christine Luque, PT, DPT
• Luxottica of America Inc
• Luxottica of America Inc.
• Patricia Ann Mahmarian, LCSW
• Jonah Micah Mateos

All providers in Edgewater, NJ · Optometrist in New Jersey