Provider Demographics
NPI:1316469133
Name:MUNSHI, OMAR (OD)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:MUNSHI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2273
Mailing Address - Country:US
Mailing Address - Phone:203-919-2048
Mailing Address - Fax:
Practice Address - Street 1:25 SOUTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4137
Practice Address - Country:US
Practice Address - Phone:973-538-5287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00676900152W00000X
NJ27OA00676901152W00000X
CT3027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist