Provider Demographics
NPI:1891061677
Name:YVONNE MORILLO
Entity Type:Organization
Organization Name:YVONNE MORILLO
Other - Org Name:ALPS FAMILY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KERSULEC-MORILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-628-0100
Mailing Address - Street 1:1386 ALPS RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3604
Mailing Address - Country:US
Mailing Address - Phone:973-628-0100
Mailing Address - Fax:
Practice Address - Street 1:1386 ALPS RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3604
Practice Address - Country:US
Practice Address - Phone:973-628-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00575800152W00000X
NJ27TO00115600152W00000X
NJ27OA00566200152W00000X
NJ27TO00105801152W00000X
NJ27OM00086403152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty