Healthcare Provider Details

I. General information

NPI: 1679464960
Provider Name (Legal Business Name): MILLTOWN FAMILY VISION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 N MAIN ST
MILLTOWN NJ
08850-1571
US

IV. Provider business mailing address

36 N MAIN ST
MILLTOWN NJ
08850-1571
US

V. Phone/Fax

Practice location:
  • Phone: 732-828-2246
  • 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: STEVEN CLAIR
Title or Position: BILLING MANAGER
Credential:
Phone: 847-651-6596