| NPI | 1346342466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYN OTERO Billing Manager 856-845-7968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2025-10-09 |