Provider Demographics
NPI:1578030011
Name:INVISION EYECARE SPECIALISTS
Entity Type:Organization
Organization Name:INVISION EYECARE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-210-0140
Mailing Address - Street 1:1 STATE ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5895
Mailing Address - Country:US
Mailing Address - Phone:732-210-0140
Mailing Address - Fax:
Practice Address - Street 1:1 STATE ROUTE 70
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5895
Practice Address - Country:US
Practice Address - Phone:732-210-0140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MB07214600OtherNEW JERSEY MEDICAL LICENSE