MEDICARE: OCEAN CITY VISION CENTER

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	NJ1504	NJ

General Provider Information

NPI Number	:	1457496333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN CITY VISION CENTER

Provider Business Mailing Address
First Line	:	752 ASBURY AVE
Second Line	:
City	:	OCEAN CITY
State	:	NJ
Zip	:	08226
Country	:	US
Telephone Number	:	609-391-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	752 ASBURY AVE
Second Line	:
City	:	OCEAN CITY
State	:	NJ
Zip	:	08226-3721
Country	:	US
Telephone Number	:	609-391-2121
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVE NICKELSBERG
Credential	:
Telephone Number	:	609-391-2121

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	01/17/2008

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Directions to “OCEAN CITY VISION CENTER ” Practice Location

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