| NPI | 1962525584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAWN C PERNELLI Office Administrator 856-205-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00581400) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ MA56275) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |