| NPI | 1811276975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE AVERGON Owner 732-688-8225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2011-08-08 |