Provider Demographics
NPI:1427065143
Name:STEIN, RICHARD L (OD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:STEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1595 RTE 23
Mailing Address - Street 2:#2
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-7508
Mailing Address - Country:US
Mailing Address - Phone:973-696-7089
Mailing Address - Fax:973-633-1307
Practice Address - Street 1:1595 RTE 23
Practice Address - Street 2:#2
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-7508
Practice Address - Country:US
Practice Address - Phone:973-696-7089
Practice Address - Fax:973-633-1307
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00343600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ270A00343600OtherLICENSE
NJ270A00343600OtherLICENSE