Provider Demographics
NPI:1629382403
Name:FRANKLIN FAMILY EYECARE, PA
Entity Type:Organization
Organization Name:FRANKLIN FAMILY EYECARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:MBONG
Authorized Official - Last Name:NGONG-TAWE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-319-0132
Mailing Address - Street 1:86 NOSTRAND RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4290
Mailing Address - Country:US
Mailing Address - Phone:732-319-0132
Mailing Address - Fax:908-725-4303
Practice Address - Street 1:454 ELIZABETH AVENUE
Practice Address - Street 2:
Practice Address - City:FRANKLIN TWP
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-319-0132
Practice Address - Fax:908-725-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00564200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8503303Medicaid
NJ1912075276OtherNPI
NJ051609Medicare PIN
NJU87208Medicare UPIN