Active NPI
Kelly Marie Ludden-Liauw, O.D.
- Optometrist
- Edgewater, NJ
National Provider Identifier
1124011200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 27OA00679900
- Practice address
- 70 The Promenade
Edgewater, NJ 07020-2127 - Phone
- (201) 945-5487
- NPI assigned
- Aug 24, 2005
- Last updated
- Oct 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TUV006690 | NY | |
| Optometrist | 152W00000X | 27OA00679900 | NJ | Primary |
Addresses
Primary practice location
70 The Promenade
Edgewater, NJ 07020-2127
Mailing address
70 The Promenade
Edgewater, NJ 07020-2127
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27OA00679900 | NJ | MD | Optometrist |
| TUV006690 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promenade Eye Care, P.a. | Optometrist | Past | Accepting new patients |
| Robert Friedman MD PC | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Pompton Plains, NJ
- NPI 1225283948
-
- Specialist
- New York, NY
- NPI 1356419956
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"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
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.