Provider Demographics
NPI:1467623272
Name:SEPPY, CHARLES MATTHEW
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:MATTHEW
Last Name:SEPPY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 ROUTE 9 SOUTH
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210
Mailing Address - Country:US
Mailing Address - Phone:609-465-2728
Mailing Address - Fax:609-465-2739
Practice Address - Street 1:315 ROUTE 9 SOUTH
Practice Address - Street 2:SUITE 1
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210
Practice Address - Country:US
Practice Address - Phone:609-465-2728
Practice Address - Fax:609-465-2739
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD-1326156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0183330001Medicare NSC