Provider Demographics
NPI:1255723128
Name:THE EYE DOCTOR, LLC
Entity type:Organization
Organization Name:THE EYE DOCTOR, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-306-5656
Mailing Address - Street 1:326 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2524
Mailing Address - Country:US
Mailing Address - Phone:732-677-3700
Mailing Address - Fax:732-677-3701
Practice Address - Street 1:326 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2524
Practice Address - Country:US
Practice Address - Phone:732-677-3700
Practice Address - Fax:732-677-3701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE EYE DOCTOR, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00606400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty