Provider Demographics
NPI:1295021947
Name:SMART, YELENA (OD)
Entity type:Individual
Prefix:DR
First Name:YELENA
Middle Name:
Last Name:SMART
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 1:55 N GILBERT ST STE 4101
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4961
Mailing Address - Country:US
Mailing Address - Phone:732-842-4751
Mailing Address - Fax:732-842-1573
Practice Address - Street 1:55 N GILBERT ST STE 4101
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07701-4961
Practice Address - Country:US
Practice Address - Phone:732-842-4751
Practice Address - Fax:732-842-1573
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00671100152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation