Provider Demographics
NPI:1568125680
Name:FRIEDBERG EYE ASSOCIATES PA
Entity Type:Organization
Organization Name:FRIEDBERG EYE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:OTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-845-7968
Mailing Address - Street 1:661 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1621
Mailing Address - Country:US
Mailing Address - Phone:856-845-7968
Mailing Address - Fax:856-345-1792
Practice Address - Street 1:412 EWAN RD STE A
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-3707
Practice Address - Country:US
Practice Address - Phone:856-845-7968
Practice Address - Fax:856-345-1792
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIEDBERG EYE ASSOICATES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier