DR. JACK LAWRENCE GOLDBERG (NPI# 1770610362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770610362 |
| Entity Type | Individual |
| Full Name | DR. JACK LAWRENCE GOLDBERG |
| Credential | O.D. |
| Practice Address |
1562 Lemoine Ave Fort Lee NJ 07024-5652 |
| Mailing Address |
105 Shepherd Ln Roslyn Heights NY 11577-2508 |
| Practice Telephone | 2014617595 |
| Mailing Telephone | 5166219227 |
| Mailing Fax Number | 2014617595 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
27TO000023500 | NJ | Eye and Vision Services Providers |
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
27OA00287200 | NJ | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | EYEMED | 111035 | 01 |
| SPECTERA | JG05092 | 01 | |
| GHI | 0071061 | 01 | |
| DAVIS VISION | 30218 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083790174 | Jack B Goldberg | Family Medicine | 4801 S Congress Ave, Suite 306, Lake Worth, FL 33461-4746 | 2006-10-31 |
| 1548372022 | Jack Goldberg | Internal Medicine | 51 N. 39th Street, 103a Medical Arts Building, Philadelphia, PA 19104-2640 | 2006-08-31 |
| Street Address |
1562 LEMOINE AVE |
| City | FORT LEE |
| State | NJ |
| Zip Code | 07024-5652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922110923 | Fort Lee Pharmacy & Surgical Inc | Pharmacy | 1562 Lemoine Ave, Fort Lee, NJ 07024-5652 | 2006-08-31 |
| 1770093544 | Fort Lee Pharmacy & Surgical Inc | Pharmacy | 1562 Lemoine Ave, Fort Lee, NJ 07024-5652 | 2017-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043828726 | You S Jung | Pharmacist | 1275 15th Street Apt 2e, Fort Lee, NJ 07024 | 2020-07-17 |
| 1205316528 | Professional Orthopedic and Sports Therapy of Nj, LLC | Physical Therapist | 2200 Fletcher Ave Ste 505, Fort Lee, NJ 07024 | 2018-08-16 |
| 1194210138 | Hyunjoo Lee | Pharmacy | 168 Fletcher Ave, Fort Lee, NJ 07024 | 2018-06-22 |
| 1912423724 | Fort Lee Health Supplies | Durable Medical Equipment & Medical Supplies | 96 Linwood Plaza Rte 9 W, Fort Lee, NJ 07024 | 2017-08-15 |
| 1669997482 | Jinseok Woo | Acupuncturist | 6 Horizon Rd., Apt 2504, Fort Lee, NJ 07024 | 2017-08-14 |
| 1578083705 | Sheran Rey | Licensed Vocational Nurse | 6308 Hilltop Ct, Fort Lee, NJ 07024 | 2017-06-20 |
| 1558812909 | Jian Cui | Acupuncturist | 500 Linwood Drive Apt3c, Fort Lee, NJ 07024 | 2016-10-20 |
| 1013392919 | Yulong Yang | Internal Medicine | 2083 Center Ave Ste 2a, Fort Lee, NJ 07024 | 2015-07-22 |
| 1235561796 | Anthony Lucev | Student in an Organized Health Care Education/Training Program | 233 Harmon Ave, Fort Lee, NJ 07024 | 2013-08-06 |
| 1811331598 | Bridgeview Rehabilitation and Medical Arts Center | Physical Medicine & Rehabilitation | 454 Main Street 3rd Floor, Fort Lee, NJ 07024 | 2013-04-24 |
| Find all providers in zip 07024 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326527292 | Beyond 20 20 Family Eye Care Inc | Optometrist | 579 Cranbury Rd Ste I, East Brunswick, NJ 08816-5405 | 2018-08-10 |
| 1255887964 | Wayne Optometric Associates LLC | Optometrist | 1595-2 Rt. 23 So., Wayne, NJ 07470-7508 | 2016-09-01 |
| 1326319948 | Better Sight Inc | Optometrist | 436 Main St., C/o Sears Optical, Hackensack, NJ 07601 | 2012-01-13 |
| 1851624605 | Rachel Landa Langer | Optometrist | 616 New Bridge Rd, Teaneck, NJ 07666 | 2009-09-11 |
| 1215164991 | James Edward Lacotte | Optometrist | 311 Main Street, Madison, NJ 07940-1814 | 2009-06-19 |
| 1538387485 | Pompton Eye and Vision Care, L.L.C. | Optometrist | 496 Newark Pompton Tpke, Pompton Plains, NJ 07444-1930 | 2007-04-23 |
| 1992828099 | Sharon Carol Stein | Optometrist | 315 State Highway 15 North, Wharton, NJ 07885 | 2007-04-06 |
| 1508983354 | Daniel H. Isaac | Optometrist | 1032 Cherry Hill Mall, Cherry Hill, NJ 08002-2100 | 2007-03-26 |
| 1801910740 | Ehrenworth & Goldsmith | Optometrist | 151 Union Blvd, Totowa, NJ 07512-2602 | 2007-03-18 |
| 1629192620 | Paul D Difiore | Optometrist | 3223 Route 38, Mount Laurel, NJ 08054-9746 | 2007-03-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.