| NPI | 1356352215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A G PORTFOLIO Doctor 201-445-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1100X Technician/Technologist, Ophthalmic (Licence: NJ 25MA03882000) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |