Provider Demographics
NPI:1912094079
Name:ASSOCIATED EYE PHYSICIANS & SURGEONS OF N.J., P.A.
Entity Type:Organization
Organization Name:ASSOCIATED EYE PHYSICIANS & SURGEONS OF N.J., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:NATALE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-382-7473
Mailing Address - Street 1:1530 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2750
Mailing Address - Country:US
Mailing Address - Phone:732-382-7473
Mailing Address - Fax:732-382-9045
Practice Address - Street 1:1050 GALLOPING HILL RD
Practice Address - Street 2:SUITE 104
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7983
Practice Address - Country:US
Practice Address - Phone:732-382-7473
Practice Address - Fax:732-382-9045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03971300207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ099185Medicare ID - Type Unspecified
0968030001Medicare NSC