Provider Demographics
NPI:1659714673
Name:APM OPTICAL CORPORATION
Entity Type:Organization
Organization Name:APM OPTICAL CORPORATION
Other - Org Name:LYNCHWOOD OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-428-8084
Mailing Address - Street 1:118 BARCLAY SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2163
Mailing Address - Country:US
Mailing Address - Phone:856-428-8084
Mailing Address - Fax:856-428-3233
Practice Address - Street 1:118 BARCLAY SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2163
Practice Address - Country:US
Practice Address - Phone:856-428-8084
Practice Address - Fax:856-428-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ04802332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier