Provider Demographics
NPI:1164577193
Name:NEW JERSEY EYECARE ASSOCIATES OD PA
Entity Type:Organization
Organization Name:NEW JERSEY EYECARE ASSOCIATES OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-777-9296
Mailing Address - Street 1:1006 US HIGHWAY 46
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2443
Mailing Address - Country:US
Mailing Address - Phone:973-777-9296
Mailing Address - Fax:973-777-9297
Practice Address - Street 1:1006 US HIGHWAY 46
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2443
Practice Address - Country:US
Practice Address - Phone:973-777-9296
Practice Address - Fax:973-777-9297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4594152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty