Provider Demographics
NPI:1851372270
Name:DR. HARVEY L. KERKER & DR. IVY H. SPEARS, OPTOMETRIC PHYSICIANS, L.L.P
Entity type:Organization
Organization Name:DR. HARVEY L. KERKER & DR. IVY H. SPEARS, OPTOMETRIC PHYSICIANS, L.L.P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KERKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-349-2020
Mailing Address - Street 1:40 BEY LEA RD
Mailing Address - Street 2:BEY LEA COMMONS SUITE C 104
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2900
Mailing Address - Country:US
Mailing Address - Phone:732-349-2020
Mailing Address - Fax:732-341-1652
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:BEY LEA COMMONS SUITE C 104
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2900
Practice Address - Country:US
Practice Address - Phone:732-349-2020
Practice Address - Fax:732-341-1652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2341813000OtherAMERIHEALTH GROUP ID NUMB
NJ24109OtherSPECTERA GROUP ID NUMBER
NJ50596OtherDAVIS VISION GROUP ID NUM
NJ0055395Medicaid
NJG3410217OtherOXFORD GROUP ID NUMBER
NJ24109OtherSPECTERA GROUP ID NUMBER
NJ0055395Medicaid
NJG3410217OtherOXFORD GROUP ID NUMBER
NJ=========OtherHORIZON BC/BS