Provider Demographics
NPI:1912195140
Name:ADVANCED EYE MDS, P.C.
Entity Type:Organization
Organization Name:ADVANCED EYE MDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:NAGELBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-253-8686
Mailing Address - Street 1:1260 ROUTE 28
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3390
Mailing Address - Country:US
Mailing Address - Phone:908-253-8686
Mailing Address - Fax:908-253-0808
Practice Address - Street 1:1260 ROUTE 28
Practice Address - Street 2:SUITE 8
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3390
Practice Address - Country:US
Practice Address - Phone:908-253-8686
Practice Address - Fax:908-253-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA62798207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty