Provider Demographics
NPI:1144384496
Name:VINELAND EYE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:VINELAND EYE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOLDSCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-825-8999
Mailing Address - Street 1:3849 S DELSEA DR
Mailing Address - Street 2:SPACE C1
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7408
Mailing Address - Country:US
Mailing Address - Phone:856-825-8999
Mailing Address - Fax:856-825-8233
Practice Address - Street 1:3849 S DELSEA DR
Practice Address - Street 2:SPACE C1
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7408
Practice Address - Country:US
Practice Address - Phone:856-825-8999
Practice Address - Fax:856-825-8233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00461700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
058687Medicare ID - Type Unspecified