Provider Demographics
NPI:1659433142
Name:ATHWAL EYE ASSOCIATES, P.C
Entity Type:Organization
Organization Name:ATHWAL EYE ASSOCIATES, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ATHWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-286-0900
Mailing Address - Street 1:14 MULE ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5028
Mailing Address - Country:US
Mailing Address - Phone:732-286-0900
Mailing Address - Fax:732-244-6063
Practice Address - Street 1:14 MULE ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5028
Practice Address - Country:US
Practice Address - Phone:732-286-0900
Practice Address - Fax:732-244-6063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA044009152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U81056Medicare UPIN
NJC56870Medicare UPIN
NJE40976Medicare UPIN
NJ0936780001Medicare NSC