Healthcare Provider Details

I. General information

NPI: 1952534885
Provider Name (Legal Business Name): FIELDS OF VISION INC MARSHALL A FIELD OD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 08/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 ROUTE 130
NORTH BRUNSWICK NJ
08902-3079
US

IV. Provider business mailing address

1825 ROUTE 130
NORTH BRUNSWICK NJ
08902-3079
US

V. Phone/Fax

Practice location:
  • Phone: 732-422-8200
  • Fax: 732-422-8204
Mailing address:
  • Phone: 732-422-8200
  • Fax: 732-422-8204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA005254
License Number StateNJ

VIII. Authorized Official

Name: DR. DEBBIE MICHELE FIELD
Title or Position: OPTOMETRIST
Credential: OD
Phone: 732-794-9028