Provider Demographics
NPI:1609925726
Name:VINCENT J MCGLONE OD
Entity Type:Organization
Organization Name:VINCENT J MCGLONE OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCGLONE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-467-2288
Mailing Address - Street 1:249 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1122
Mailing Address - Country:US
Mailing Address - Phone:973-467-2288
Mailing Address - Fax:973-467-1455
Practice Address - Street 1:249 MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1122
Practice Address - Country:US
Practice Address - Phone:973-467-2288
Practice Address - Fax:973-467-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA005694152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU51467Medicare UPIN
MA4393970001Medicare NSC