Provider Demographics
NPI:1770859035
Name:DUFFY FAMILY EYE CARE, PC
Entity Type:Organization
Organization Name:DUFFY FAMILY EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:484-889-8985
Mailing Address - Street 1:1 W CLIFF ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1901
Mailing Address - Country:US
Mailing Address - Phone:908-725-2915
Mailing Address - Fax:908-725-6580
Practice Address - Street 1:1 W CLIFF ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1901
Practice Address - Country:US
Practice Address - Phone:908-725-2915
Practice Address - Fax:908-725-6580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000992152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0221473Medicaid