Provider Demographics
NPI:1316185044
Name:MONROE EYE CARE NJ, LLC
Entity Type:Organization
Organization Name:MONROE EYE CARE NJ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEFALI
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLANI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:609-235-9770
Mailing Address - Street 1:1600 PERRINEVILLE RD
Mailing Address - Street 2:STORE # 32
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4923
Mailing Address - Country:US
Mailing Address - Phone:609-235-9770
Mailing Address - Fax:609-235-9771
Practice Address - Street 1:1600 PERRINEVILLE RD
Practice Address - Street 2:STORE # 32
Practice Address - City:MONROE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08831-4923
Practice Address - Country:US
Practice Address - Phone:609-235-9770
Practice Address - Fax:609-235-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00600700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ142840Medicare PIN