Provider Demographics
NPI:1124432323
Name:ROBERT H. CAMERON, O.D., P.A.
Entity type:Organization
Organization Name:ROBERT H. CAMERON, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HECTOR
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:201-652-1531
Mailing Address - Street 1:190 DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4422
Mailing Address - Country:US
Mailing Address - Phone:201-652-1531
Mailing Address - Fax:201-652-6436
Practice Address - Street 1:190 DAYTON ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4422
Practice Address - Country:US
Practice Address - Phone:201-652-1531
Practice Address - Fax:201-652-6436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U26810Medicare UPIN