David Iosebashvili, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA 00592800 Issued in NJ

Practice address

766 Bloomfield Ave.
West Caldwell, NJ 07006

Phone

(973) 882-1967

Fax

(973) 882-5553

NPI assigned

Aug 11, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Contact Lens and Vision Associates, P.a

  • Optometrist
  • Freehold, NJ
  • NPI 1922211978
  NPD (past)
• Contact Lens and Vision Consultants, P.a

  • Optometrist
  • Woodbridge, NJ
  • NPI 1568674497
  NPD (past)
• John M. Aljian, MD, PC

  • Ophthalmology Physician
  • Yonkers, NY
  • NPI 1285855387
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831100031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 BLOOMFIELD AVE.",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "07006",
            "telephone_number": "973-882-1967",
            "fax_number": "973-882-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 BLOOMFIELD AVE.",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "07006",
            "telephone_number": "973-882-1967",
            "fax_number": "973-882-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IOSEBASHVILI",
        "first_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA 00592800",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV 006788",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID NUMBER",
            "identifier": "3973690",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Ryan Holland
• Tara P Horvat, M.A. CCC-SLP
• Jamie Nicole Hreniuk, DPT
• In Her Image- West Caldwell, LLC
• Intensive Therapeutics, Inc
• Ulrick Jean-Pierre
• Jersey Dialysis Centers, LLC (Jersey Dialysis Centers)
• Jewish Service for the Developmentally Disabled of Metrowest, Inc.
• Jewish Service for the Developmentally Disabled of Metrowest, Inc.
• Marcela K Jimenez

• Optometrist in West Caldwell, NJ
• Providers in West Caldwell, 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 9, 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.