Provider Demographics
NPI:1508135146
Name:VISUAL EYES EYECARE
Entity Type:Organization
Organization Name:VISUAL EYES EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONDO
Authorized Official - Suffix:
Authorized Official - Credentials:OPT
Authorized Official - Phone:973-691-0700
Mailing Address - Street 1:90-140 ROUTE 206
Mailing Address - Street 2:BYRAM PLAZA
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:90-140 ROUTE 206
Practice Address - Street 2:BYRAM PLAZA
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874
Practice Address - Country:US
Practice Address - Phone:973-691-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty