| NPI | 1992151716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIVAN PHILLIPS GENDY Optometrist 732-387-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27OA00621300) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |