Provider Demographics
NPI:1902389869
Name:COMPLETE VISION SERVICES
Entity Type:Organization
Organization Name:COMPLETE VISION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MADREPERLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-458-8333
Mailing Address - Street 1:1000 GALLOPING HILL RD STE 305
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7991
Mailing Address - Country:US
Mailing Address - Phone:908-458-8333
Mailing Address - Fax:
Practice Address - Street 1:1000 GALLOPING HILL RD STE 305
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-458-8333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSOCIATED RETINAL CONSULTANTS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-07
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty