Provider Demographics
NPI:1497917520
Name:ADVANCED EYE PROFESSIONALS LLC
Entity Type:Organization
Organization Name:ADVANCED EYE PROFESSIONALS LLC
Other - Org Name:BRIGHTON EYE CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PENEIRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-792-9800
Mailing Address - Street 1:225 GORDONS CORNER RD
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3356
Mailing Address - Country:US
Mailing Address - Phone:732-792-9800
Mailing Address - Fax:
Practice Address - Street 1:225 GORDONS CORNER RD
Practice Address - Street 2:SUITE 1C
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3356
Practice Address - Country:US
Practice Address - Phone:732-792-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270M00031600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8358401Medicaid
NJ039686OtherMEDICARE ID - TYPE UNSPECIFIED
248549Medicare PIN
NJU81056Medicare UPIN