DR. SUPATRA LAKSANASUT (NPI# 1568656056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568656056 |
| Entity Type | Individual |
| Full Name | DR. SUPATRA LAKSANASUT |
| Credential | O.D. |
| Practice Address |
1130 Highway 77 Bridgeton NJ 08302-5988 |
| Practice Telephone | 8564530418 |
| Mailing Telephone | 8564530418 |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 27OA00610200 | NJ | Eye and Vision Services Providers |
| Street Address |
1130 HIGHWAY 77 |
| City | BRIDGETON |
| State | NJ |
| Zip Code | 08302-5988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619994753 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1130 Highway 77, Bridgeton, NJ 08302-5988 | 2006-07-16 |
| 1508106105 | Duszak Eye Associates, LLC | Optometrist | 1130 Highway 77, Bridgeton, NJ 08302-5988 | 2013-02-20 |
| 1871840637 | Robert Arnold Birdsall | Pharmacist | 1130 Highway 77, Bridgeton, NJ 08302-5988 | 2012-08-12 |
| 1235232869 | Wal-mart Stores East, Lp | Technician/Technologist | 1130 Highway 77, Bridgeton, NJ 08302-5988 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508390196 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Northwest Drive, Bridgeton, NJ 08302 | 2017-04-20 |
| 1124552716 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 198 Roadstown Road, Bridgeton, NJ 08302 | 2017-04-20 |
| 1861926453 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 555 Burlington Road, Bridgeton, NJ 08302 | 2017-04-20 |
| 1306370994 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 92 Princeton Avenue, Bridgeton, NJ 08302 | 2017-04-20 |
| 1205360245 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 50 Roberts Avenue, Bridgeton, NJ 08302 | 2017-04-17 |
| 1649704602 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 28 West Park Drive, Bridgeton, NJ 08302 | 2017-04-17 |
| 1871043299 | Leah Sadler | Counselor | 90 S Burlington Rd, 189, Bridgeton, NJ 08302 | 2016-10-10 |
| 1245695428 | Bkt High Quality Healthcare Agency LLC | Home Health | 6 South Laurel St., 2nd Floor, Bridgeton, NJ 08302 | 2015-12-15 |
| 1073986493 | Caringhouse Projects, Inc | Respite Care | 1040 Laurel Lane, Deerfield Township, NJ 08302 | 2015-11-06 |
| 1174903256 | Christopher Struby | Internal Medicine | 201 Laurel Heights Dr # 201, Bridgeton, NJ 08302 | 2015-06-04 |
| Find all providers in zip 08302 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689921314 | Tareq I. Nabhan | Optometrist | 12110 Saint Charles Rock Rd, Bridgeton, MO 63044-2601 | 2012-08-13 |
| 1285818542 | Jermik Systems, Ltd | Optometrist | 3454 Mckelvey Rd, Bridgeton, MO 63044-2533 | 2007-12-21 |
| 1366438939 | South Jersey Eye Associates Pa | Optometrist | 205 Laurel Heights Dr, Bridgeton, NJ 08302-3635 | 2005-09-20 |
| 1073124871 | Russell Wayne Chappius IIi | Optometrist | 205 Laurel Heights Dr, Bridgeton, NJ 08302-3635 | 2020-08-14 |
| 1053702381 | Crescent Eyecare | Optometrist | 12110 Saint Charles Rock Rd, Bridgeton, MO 63044-2601 | 2015-02-09 |
| 1730586629 | Nucrown, LLC | Optometrist | 3454 Mckelvey Rd, Bridgeton, MO 63044-2533 | 2014-11-21 |
| 1710310610 | Brandon Jon Wuzzardo | Optometrist | 205 Laurel Heights Dr, Bridgeton, NJ 08302-3635 | 2013-08-14 |
| 1508106105 | Duszak Eye Associates, LLC | Optometrist | 1130 Highway 77, Bridgeton, NJ 08302-5988 | 2013-02-20 |
| 1407054943 | Kimberly Ann Layfield | Optometrist | 12255 Depaul Drive, Suite 360, Bridgeton, MO 63044-2510 | 2007-07-05 |
| 1700816816 | Community Health Care Inc. | Optometrist | 70 Cohansey St, Bridgeton, NJ 08302-1918 | 2006-07-04 |
| Find all providers in BRIDGETON | ||||
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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.