Provider Demographics
NPI:1679750376
Name:OPHTHALMIC ASSOCIATES, PA
Entity type:Organization
Organization Name:OPHTHALMIC ASSOCIATES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-696-0020
Mailing Address - Street 1:1051 W SHERMAN AVE STE 5A
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6931
Mailing Address - Country:US
Mailing Address - Phone:856-691-0504
Mailing Address - Fax:856-205-1721
Practice Address - Street 1:1051 W SHERMAN AVE STE 5A
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6931
Practice Address - Country:US
Practice Address - Phone:856-691-0504
Practice Address - Fax:856-205-1721
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPHTHALMIC ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3166332B00000X
NJ3451332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0295100001Medicare NSC