Provider Demographics
NPI:1073119665
Name:CHESTER FAMILY EYE CARE LLC
Entity Type:Organization
Organization Name:CHESTER FAMILY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR OF OPTOMETRY
Authorized Official - Prefix:DR
Authorized Official - First Name:AVI
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:YEHUDAI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-742-8934
Mailing Address - Street 1:530 MAIN ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2669
Mailing Address - Country:US
Mailing Address - Phone:908-879-7070
Mailing Address - Fax:908-879-5323
Practice Address - Street 1:530 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2669
Practice Address - Country:US
Practice Address - Phone:908-879-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2021-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ27OA00680100OtherNJ LICENSE