Healthcare Provider Details

I. General information

NPI: 1699262832
Provider Name (Legal Business Name): ENFOCUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 04/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 S HADDON AVE UNIT 2151
HADDONFIELD NJ
08033-8057
US

IV. Provider business mailing address

25 S HADDON AVE UNIT 2151
HADDONFIELD NJ
08033-8057
US

V. Phone/Fax

Practice location:
  • Phone: 267-380-0126
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: PRIYA DESAI PATEL
Title or Position: MEMBER
Credential:
Phone: 704-819-2671