Provider Demographics
NPI:1104836428
Name:IB VISION
Entity Type:Organization
Organization Name:IB VISION
Other - Org Name:IB VISION SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGGAN
Authorized Official - Middle Name:CLAIR
Authorized Official - Last Name:HEINZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-486-3333
Mailing Address - Street 1:515 N WOOD AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4173
Mailing Address - Country:US
Mailing Address - Phone:908-486-3333
Mailing Address - Fax:908-486-7475
Practice Address - Street 1:515 N WOOD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4173
Practice Address - Country:US
Practice Address - Phone:908-486-3333
Practice Address - Fax:908-486-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00597900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty