Provider Demographics
NPI:1447385281
Name:THE EYE-SITE
Entity Type:Organization
Organization Name:THE EYE-SITE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:BONFIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-589-2939
Mailing Address - Street 1:415 EGG HARBOR RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9211
Mailing Address - Country:US
Mailing Address - Phone:856-589-2939
Mailing Address - Fax:856-589-5225
Practice Address - Street 1:415 EGG HARBOR RD
Practice Address - Street 2:SUITE 14
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9211
Practice Address - Country:US
Practice Address - Phone:856-589-2939
Practice Address - Fax:856-589-5225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00070800332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies