Provider Demographics
NPI:1578624037
Name:FRIDEL EYE ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:FRIDEL EYE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FRIDEL
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:732-775-3805
Mailing Address - Street 1:516 BANGS AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6902
Mailing Address - Country:US
Mailing Address - Phone:732-775-3805
Mailing Address - Fax:732-775-3807
Practice Address - Street 1:516 BANGS AVE
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-6902
Practice Address - Country:US
Practice Address - Phone:732-775-3805
Practice Address - Fax:732-775-3807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA005921152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty