Provider Demographics
NPI:1760470405
Name:EYEXAM ASSOCIATES PA
Entity Type:Organization
Organization Name:EYEXAM ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-482-2933
Mailing Address - Street 1:2432 ROUTE 38
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1238
Mailing Address - Country:US
Mailing Address - Phone:856-482-2933
Mailing Address - Fax:856-482-2936
Practice Address - Street 1:2432 ROUTE 38
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-1238
Practice Address - Country:US
Practice Address - Phone:856-482-2933
Practice Address - Fax:856-482-2936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00419000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
57221OtherAETNA
571884OtherHIGHMARK
0393359000OtherAMERIHEALTH
NJ3397807Medicaid
0649747004OtherCIGNA
16636OtherAVESIS
G119398OtherOXFORD
10561OtherSPECTERA
10561OtherSPECTERA
0393359000OtherAMERIHEALTH
0649747004OtherCIGNA
NJCM7626Medicare PIN