Provider Demographics
NPI:1194560433
Name:GIRGIS, EMI J (OD)
Entity type:Individual
Prefix:
First Name:EMI
Middle Name:J
Last Name:GIRGIS
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 1:257 MONMOUTH RD STE 1B
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1501
Mailing Address - Country:US
Mailing Address - Phone:732-835-2020
Mailing Address - Fax:
Practice Address - Street 1:257 MONMOUTH RD STE 1B
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1501
Practice Address - Country:US
Practice Address - Phone:732-835-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00730700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist