Provider Demographics
NPI:1417348988
Name:LIBERTY EYE CARE II
Entity Type:Organization
Organization Name:LIBERTY EYE CARE II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GAMUZZA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-925-8901
Mailing Address - Street 1:90 PASSAIC AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-1106
Mailing Address - Country:US
Mailing Address - Phone:732-925-8901
Mailing Address - Fax:
Practice Address - Street 1:90 PASSAIC AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-1106
Practice Address - Country:US
Practice Address - Phone:732-925-8901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty