Provider Demographics
NPI:1629691910
Name:ADVANCED EYECARE OF EDGEWATER INC
Entity Type:Organization
Organization Name:ADVANCED EYECARE OF EDGEWATER INC
Other - Org Name:EDGEWATER EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-653-8849
Mailing Address - Street 1:3665 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-2343
Mailing Address - Country:US
Mailing Address - Phone:610-653-8849
Mailing Address - Fax:
Practice Address - Street 1:75 RIVER RD STE 210
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1075
Practice Address - Country:US
Practice Address - Phone:201-340-6406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty