Provider Demographics
NPI:1699926287
Name:LEMBERG, NINA (OD)
Entity type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:LEMBERG
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 1:18 ROUTE 9 NORTH
Mailing Address - Street 2:INSIDE COSTCO OPTICAL
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-0000
Mailing Address - Country:US
Mailing Address - Phone:732-617-4355
Mailing Address - Fax:
Practice Address - Street 1:18 ROUTE 9 NORTH
Practice Address - Street 2:INSIDE COSTCO OPTICAL
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-0000
Practice Address - Country:US
Practice Address - Phone:732-617-4355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00617700152W00000X
NJ27OM00074000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist