Optometric Physicians of Long Branch LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00542500 Issued in NJ

Legal business name

OPTOMETRIC PHYSICIANS OF LONG BRANCH LLC

Practice address

444 Ocean Blvd
Ursula Plaza
Long Branch, NJ 07740-5651

Phone

(732) 870-0600

Fax

(732) 870-0020

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Todd H Gershenow, O.D.

Title

Owner

Phone

(732) 671-7300

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• EyesFirst Vision Center Doing business as

Locations

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246492800000",
    "number": "1780790097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 OCEAN BLVD",
            "address_2": "URSULA PLAZA",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077405651",
            "telephone_number": "732-870-0600",
            "fax_number": "732-870-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 OCEAN BLVD",
            "address_2": "URSULA PLAZA",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077405651",
            "telephone_number": "732-870-0600",
            "fax_number": "732-870-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC PHYSICIANS OF LONG BRANCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-07-02",
        "status": "A",
        "authorized_official_last_name": "GERSHENOW",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-671-7300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00542500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8378801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EyesFirst Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shakirat Odukale, APN
• Bismark Oduro, MD
• Jolaade Olatunji, MSW
• Beatrice Elizabeth Baysa Ong
• Optometric Physcians of Long Branch
• Jessica Marie Orgovan, DO
• Martha C Ortiz, C.N.M.
• Natasha Ortiz
• Rashidat Owolabi-Adedokun, MD
• Sarah Padula

• Optometrist in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2009; 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.