| NPI | 1821007261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BLINDERMAN BANNETT Practice Administrator 856-853-5554 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MB04846500) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-12-16 |