Provider Demographics
NPI:1770630741
Name:20/20 VISION ASSOCIATES PC
Entity Type:Organization
Organization Name:20/20 VISION ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-401-9453
Mailing Address - Street 1:1405 CHANTICLEER
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4823
Mailing Address - Country:US
Mailing Address - Phone:856-751-0565
Mailing Address - Fax:856-751-0565
Practice Address - Street 1:1900 DEPTFORD CENTER RD
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-5624
Practice Address - Country:US
Practice Address - Phone:856-401-9453
Practice Address - Fax:856-401-8879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00592700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU99134Medicare UPIN