| NPI | 1720044878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH MCCANN Director Of Revenue Cycle 848-219-2109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 152WC0802X Optometrist, Corneal and Contact Management | |
| 156FC0800X Technician/Technologist, Contact Lens | |
| 156FX1101X Technician/Technologist, Ophthalmic Assistant | |
| 156FX1202X Technician/Technologist, Optometric Technician | |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2023-10-12 |