Provider Demographics
NPI:1508031634
Name:SKYLINE FAMILY EYECARE PA
Entity Type:Organization
Organization Name:SKYLINE FAMILY EYECARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CURTIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-962-0040
Mailing Address - Street 1:130 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2036
Mailing Address - Country:US
Mailing Address - Phone:973-962-0040
Mailing Address - Fax:973-962-6629
Practice Address - Street 1:130 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456-2036
Practice Address - Country:US
Practice Address - Phone:973-962-0040
Practice Address - Fax:973-962-6629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5216152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3934560001Medicare NSC
NJ157198Medicare PIN