Individual
DR. ALBERT J STAAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
65 ROUTE 70 E STE 3, MARLTON, NJ 08053-1747
(856) 596-4416
Mailing address
65 ROUTE 70 E, MARLTON, NJ 08053-1747
(856) 985-0066
(856) 985-8104
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00598300
NJ
152WC0802X
Corneal and Contact Management Optometrist
27OA00598300
NJ
152WS0006X
Sports Vision Optometrist
27OA00598300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00401966
RAILROAD MEDICARE PROVIDER TRANSACTION NUMBER PTAN
NJ
Enumeration date
06/15/2006
Last updated
04/21/2021
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