| NPI | 1104256395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEILA R TAYLOR Owner 732-223-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2014-02-25 |