Provider Demographics
NPI:1598862773
Name:MARFORI FAMILY EYE CARE
Entity Type:Organization
Organization Name:MARFORI FAMILY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARFORI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-920-2203
Mailing Address - Street 1:20 BRICK PLZ
Mailing Address - Street 2:CHAMBERSBRIDGE ROAD
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4045
Mailing Address - Country:US
Mailing Address - Phone:732-920-2203
Mailing Address - Fax:
Practice Address - Street 1:20 BRICK PLZ
Practice Address - Street 2:CHAMBERSBRIDGE ROAD
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4045
Practice Address - Country:US
Practice Address - Phone:732-920-2203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00550200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5798110001Medicare NSC