Healthcare Provider Details

I. General information

NPI: 1164710844
Provider Name (Legal Business Name): DR SUN EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MARKET ST STE 920
PLAINSBORO NJ
08536-2096
US

IV. Provider business mailing address

6 MARKET ST STE 920
PLAINSBORO NJ
08536-2096
US

V. Phone/Fax

Practice location:
  • Phone: 609-799-1219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00626100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number27OA00626100
License Number StateNJ

VIII. Authorized Official

Name: DR. XIAOYIN SUN
Title or Position: O.D. OWNER
Credential: O.D.
Phone: 609-799-1219