Provider Demographics
NPI:1588712814
Name:DRS SIMMERMAN AND FLOYD PA
Entity type:Organization
Organization Name:DRS SIMMERMAN AND FLOYD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-589-1288
Mailing Address - Street 1:415 WOODBURY GLASSBORO RD
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-4559
Mailing Address - Country:US
Mailing Address - Phone:856-589-1288
Mailing Address - Fax:856-589-3437
Practice Address - Street 1:415 WOODBURY GLASSBORO RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-4559
Practice Address - Country:US
Practice Address - Phone:856-589-1288
Practice Address - Fax:856-589-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2667207Medicaid
NJ543791Medicare PIN
NJ2667207Medicaid