| NPI | 1659425551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN P PHIBBS Doctor/Owner 732-974-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: NJ 4756) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NJ 27OA00475600) |
| 156FX1800X Technician/Technologist, Optician (Licence: NJ D-1630) | |
| 156FX1800X Technician/Technologist, Optician (Licence: NJ D-2019) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2014-03-24 |