Provider Demographics
NPI:1770603110
Name:FAMILY EYECARE ASSOCIATES, PC
Entity type:Organization
Organization Name:FAMILY EYECARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-794-7977
Mailing Address - Street 1:17-10 FAIR LAWN AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2324
Mailing Address - Country:US
Mailing Address - Phone:201-794-7977
Mailing Address - Fax:201-794-7347
Practice Address - Street 1:17-10 FAIR LAWN AVE
Practice Address - Street 2:2ND FL
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2324
Practice Address - Country:US
Practice Address - Phone:201-794-7977
Practice Address - Fax:201-794-7347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00449700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT81537Medicare UPIN
NJ521589Medicare PIN