Provider Demographics
NPI:1538178371
Name:ABDUL- MASSIH, RITA (OD)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:ABDUL- MASSIH
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 1:2128 STATE ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2742
Mailing Address - Country:US
Mailing Address - Phone:732-275-0010
Mailing Address - Fax:732-275-0050
Practice Address - Street 1:131 MARKHAM PL
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1400
Practice Address - Country:US
Practice Address - Phone:732-530-2031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00585900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJM93770Medicare UPIN