Provider Demographics
NPI:1891426714
Name:MOLBEGOTT, AUSTIN (OD)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:MOLBEGOTT
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 1:300 HIGHWAY 35 STE 300
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2216
Mailing Address - Country:US
Mailing Address - Phone:732-222-7373
Mailing Address - Fax:732-483-8214
Practice Address - Street 1:300 HIGHWAY 35 STE 300
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2216
Practice Address - Country:US
Practice Address - Phone:732-222-7373
Practice Address - Fax:732-483-8214
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00186900152W00000X
PAOEG003942152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty