Provider Demographics
NPI:1043249337
Name:MONROE VISION ASSOCIATES LLC
Entity Type:Organization
Organization Name:MONROE VISION ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DONLON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:609-655-2666
Mailing Address - Street 1:337 APPLEGARTH ROAD
Mailing Address - Street 2:
Mailing Address - City:MONROE TUP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831
Mailing Address - Country:US
Mailing Address - Phone:609-655-2666
Mailing Address - Fax:609-655-2692
Practice Address - Street 1:337 APPLEGARTH ROAD
Practice Address - Street 2:
Practice Address - City:MONROE TUP
Practice Address - State:NJ
Practice Address - Zip Code:08831
Practice Address - Country:US
Practice Address - Phone:609-655-2666
Practice Address - Fax:609-655-2692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5189152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5075320002Medicare NSC
Y12416Medicare UPIN
080167Medicare ID - Type Unspecified
NJ5075320001Medicare NSC