Provider Demographics
NPI:1386601276
Name:KIRSCH, JOEL S (OD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:S
Last Name:KIRSCH
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 1:139 EVANS RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5511
Mailing Address - Country:US
Mailing Address - Phone:973-736-9700
Mailing Address - Fax:
Practice Address - Street 1:495 PROSPECT AVE
Practice Address - Street 2:ESSEX GREEN PLAZA
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-4100
Practice Address - Country:US
Practice Address - Phone:973-736-9700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4143152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist