Provider Demographics
NPI:1598796062
Name:UNION FAMILY EYECARE, PC
Entity Type:Organization
Organization Name:UNION FAMILY EYECARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NERMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GENDY
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTOR OF OPTOMETRY
Authorized Official - Phone:201-321-5442
Mailing Address - Street 1:110 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5928
Mailing Address - Country:US
Mailing Address - Phone:732-842-6610
Mailing Address - Fax:732-842-6609
Practice Address - Street 1:110 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5928
Practice Address - Country:US
Practice Address - Phone:732-842-6610
Practice Address - Fax:732-842-6609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00583400152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3521669OtherOXFORD HEALTH PLANS
NJ3779501OtherAETNA HMO
NJ7054411OtherAETNA PPO
NJ7054411OtherAETNA PPO
NJ087087Medicare PIN