Provider Demographics
NPI:1750002069
Name:MODERN VUE EYECARE
Entity type:Organization
Organization Name:MODERN VUE EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ASLAMI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:706-631-7168
Mailing Address - Street 1:23 HOPPER LN
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4656
Mailing Address - Country:US
Mailing Address - Phone:706-631-7168
Mailing Address - Fax:
Practice Address - Street 1:1508 WILLOWBROOK MALL
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-256-0060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center