Provider Demographics
NPI:1851799928
Name:MORILLO EYE ASSOCIATES UNION CITY
Entity Type:Organization
Organization Name:MORILLO EYE ASSOCIATES UNION CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTIMETRIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORILLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-621-1469
Mailing Address - Street 1:418 38TH ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-4999
Mailing Address - Country:US
Mailing Address - Phone:201-867-0199
Mailing Address - Fax:201-867-0226
Practice Address - Street 1:418 38TH ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-4999
Practice Address - Country:US
Practice Address - Phone:201-867-0199
Practice Address - Fax:201-867-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00602302152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01128442Medicaid
NJ01128442Medicaid