Provider Demographics
NPI:1740847797
Name:MAGNIFY IN-HOME EYECARE
Entity type:Organization
Organization Name:MAGNIFY IN-HOME EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROPHY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:609-618-2629
Mailing Address - Street 1:551 MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1405
Mailing Address - Country:US
Mailing Address - Phone:609-618-2629
Mailing Address - Fax:
Practice Address - Street 1:LITTLE NURSING HOME
Practice Address - Street 2:71 CHRISTOPHER STREET
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042
Practice Address - Country:US
Practice Address - Phone:973-744-5518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-24
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty