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1069 Ringwood Ave, Haskell, NJ 07420-1408 | |
(862) 200-5454 | |
(862) 200-5453 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 1069 Ringwood Ave, Haskell, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033386222 | NPI | - | NPPES |
132242 | Other | NJ | MEDICARE PTAN |
7757204 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 27OA00509800 (New Jersey) | Primary |
Provider Name | Michael A Benetatos |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1013085521 PECOS PAC ID: 8729155254 Enrollment ID: I20080924000530 |
Mailing Address | Practice Location Address |
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1069 Ringwood Ave, Haskell, NJ 07420-1408 Ph: (862) 200-5454 | 1069 Ringwood Ave, Haskell, NJ 07420-1408 Ph: (862) 200-5454 |
Dr. Michael A. Benetatos, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1069 Ringwood Ave Ste 106, Haskell, NJ 07420 Phone: 862-200-5454 |