Healthcare Provider Details

I. General information

NPI: 1154629251
Provider Name (Legal Business Name): ABBATE FAMILY EYECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2011
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 MARLTON PIKE W SUITE C
CHERRY HILL NJ
08002-2776
US

IV. Provider business mailing address

2010 MARLTON PIKE W SUITE C
CHERRY HILL NJ
08002-2776
US

V. Phone/Fax

Practice location:
  • Phone: 856-663-9494
  • Fax: 856-662-5451
Mailing address:
  • Phone: 856-663-9494
  • Fax: 856-662-5451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00594400
License Number StateNJ

VIII. Authorized Official

Name: DR. GREGG ABBATE
Title or Position: OWNER
Credential: O.D.
Phone: 856-663-9494