Provider Demographics
NPI:1568579563
Name:NEW JERSEY EYE PHYSICIANS AND SURGEONS PA
Entity Type:Organization
Organization Name:NEW JERSEY EYE PHYSICIANS AND SURGEONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-964-7900
Mailing Address - Street 1:2333 MORRIS AVE
Mailing Address - Street 2:SUITE C-115
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5714
Mailing Address - Country:US
Mailing Address - Phone:908-964-7900
Mailing Address - Fax:908-964-7911
Practice Address - Street 1:2333 MORRIS AVE
Practice Address - Street 2:SUITE C-115
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5714
Practice Address - Country:US
Practice Address - Phone:908-964-7900
Practice Address - Fax:908-964-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ161720Medicare ID - Type Unspecified