Individual
KENNETH A SHUSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4827 ATLANTIC AVE, VENTNOR, NJ 08406-3004
(609) 487-0010
(609) 487-0163
Mailing address
4827 ATLANTIC AVE, VENTNOR, NJ 08406-3004
(609) 487-0010
(609) 487-0163
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
03856
NJ
152WV0400X
Vision Therapy Optometrist
24500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0613460002
OTHER
NJ
05
—
1867008
—
NJ
Enumeration date
12/20/2005
Last updated
07/27/2011
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