Provider Demographics
NPI:1235844622
Name:COASTAL EYES LLC
Entity Type:Organization
Organization Name:COASTAL EYES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARFORI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-920-1775
Mailing Address - Street 1:2439 ROUTE 34 STE K
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1800
Mailing Address - Country:US
Mailing Address - Phone:732-449-9503
Mailing Address - Fax:732-974-7120
Practice Address - Street 1:2439 ROUTE 34 STE K
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1800
Practice Address - Country:US
Practice Address - Phone:732-449-9503
Practice Address - Fax:732-974-7120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier