Provider Demographics
NPI:1770619058
Name:HOCHSTADT-KANSKY, BEVERLY (OD)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:
Last Name:HOCHSTADT-KANSKY
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 1:118 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4649
Mailing Address - Country:US
Mailing Address - Phone:201-653-2020
Mailing Address - Fax:
Practice Address - Street 1:118 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4649
Practice Address - Country:US
Practice Address - Phone:201-653-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00451900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU77382Medicare UPIN