Provider Demographics
NPI:1942233739
Name:COVENTRY EYE ASSOCIATES PC
Entity Type:Organization
Organization Name:COVENTRY EYE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CZERWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-859-6055
Mailing Address - Street 1:800 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1973
Mailing Address - Country:US
Mailing Address - Phone:908-859-6055
Mailing Address - Fax:908-859-2042
Practice Address - Street 1:800 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1973
Practice Address - Country:US
Practice Address - Phone:908-859-6055
Practice Address - Fax:908-859-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCJ0843OtherRAILROAD
NJ0506860001Medicare NSC