Provider Demographics
NPI:1124109046
Name:HA, ESTHER C (OD)
Entity type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:C
Last Name:HA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 ROUTE 27 STE 2
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3263
Mailing Address - Country:US
Mailing Address - Phone:732-543-0706
Mailing Address - Fax:732-543-0708
Practice Address - Street 1:1945 ROUTE 27 STE 2
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3263
Practice Address - Country:US
Practice Address - Phone:732-543-0706
Practice Address - Fax:732-543-0708
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007087-1152W00000X
NJ27OA00605000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6340920001Medicare NSC
NJ1107744WH3Medicare PIN
NJV12373Medicare UPIN