Healthcare Provider Details

I. General information

NPI: 1538105036
Provider Name (Legal Business Name): EYECARE PROFESSIONALS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 KUSER RD
HAMILTON SQUARE NJ
08690-3703
US

IV. Provider business mailing address

1777 KUSER RD
HAMILTON SQUARE NJ
08690-3703
US

V. Phone/Fax

Practice location:
  • Phone: 609-581-5755
  • Fax: 609-581-7055
Mailing address:
  • Phone: 609-581-5755
  • Fax: 609-581-7055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. LISA M MACARTHUR
Title or Position: OFFICE MANAGER
Credential:
Phone: 609-581-5755