Evesham Eye Associates, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00598300 Issued in NJ

Legal business name

EVESHAM EYE ASSOCIATES, INC.

Doing business as

Marlton Eye Associates

Practice address

151 W Greentree Rd
Suite B
Marlton, NJ 08053-9416

Phone

(856) 985-0066

Fax

(856) 985-8104

NPI assigned

Aug 8, 2006

Last updated

Apr 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Albert J Staab, ODNPI 1306880257

Title

Owner

Phone

(856) 985-0066

Specialties & licenses 1

Addresses

Other names 1

• Marlton Eye Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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.

• Albert J Staab, O.D.

  • Optometrist
  • Marlton, NJ
  • NPI 1306880257
  Medicare reassignment NPD Authorized official
• Briana K Grimaldi, OD

  • Optometrist
  • Evesham, NJ
  • NPI 1740914639
  Medicare reassignment NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1619987062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 ROUTE 70 E STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531747",
            "telephone_number": "856-985-0066",
            "fax_number": "856-985-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W GREENTREE RD",
            "address_2": "SUITE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539416",
            "telephone_number": "856-985-0066",
            "fax_number": "856-985-8104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Route 70 E Ste 3",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080531747",
            "country_code": "US",
            "telephone_number": "856-596-4416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVESHAM EYE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "STAAB",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-985-0066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00598300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marlton Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dori Ertler, LPC
• Juan C. Escobedo, MS, LPC, NCC
• Gabriella Elena Esposito, M.S., CCC-SLP
• Albert Ebue Estella, P.T.
• Evesboro Dental Associates PA
• Evesham Township Board of Education
• Evesham Township Fire District No 1
• Excel Transportation Services
• Ez Health Medical Group East PC
• Michael A Falk, MD

• Optometrist in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.