MEDICARE: ADVANCED EYE GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1417006917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED EYE GROUP LLC

Provider Business Mailing Address
First Line	:	206 N MAIN RD
Second Line	:
City	:	VINELAND
State	:	NJ
Zip	:	08360-8201
Country	:	US
Telephone Number	:	856-691-0720
Fax Number	:	856-691-6163

Provider Business Practice Location Address
First Line	:	206 N MAIN RD
Second Line	:
City	:	VINELAND
State	:	NJ
Zip	:	08360-8201
Country	:	US
Telephone Number	:	856-691-0720
Fax Number	:	856-691-6163

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FRANK D'ORIO
Credential	:	OPTOMETRIST
Telephone Number	:	856-691-0720

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	05/26/2023

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