Provider Demographics
NPI:1427200039
Name:HEALTHY EYES VISION SERVICES, P.A.
Entity Type:Organization
Organization Name:HEALTHY EYES VISION SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OPTOMETRIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-738-9223
Mailing Address - Street 1:565 NEW BRUNSWICK AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-2162
Mailing Address - Country:US
Mailing Address - Phone:732-738-9223
Mailing Address - Fax:732-738-6692
Practice Address - Street 1:565 NEW BRUNSWICK AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-2162
Practice Address - Country:US
Practice Address - Phone:732-738-9223
Practice Address - Fax:732-738-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00409100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3161609Medicaid
NJ1028980001Medicare NSC
NJ3161609Medicaid