Provider Demographics
NPI:1083974026
Name:CIPPARONE EYE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CIPPARONE EYE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CIPPARONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-906-6079
Mailing Address - Street 1:111 PREAKNESS DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-3603
Mailing Address - Country:US
Mailing Address - Phone:856-906-6079
Mailing Address - Fax:
Practice Address - Street 1:2000 CLEMENTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-2016
Practice Address - Country:US
Practice Address - Phone:856-906-6079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA005489152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8997403Medicaid
NJ025366Medicare PIN
NJU69789Medicare UPIN