Healthcare Provider Details

I. General information

NPI: 1851035463
Provider Name (Legal Business Name): NAVESINK EYE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 STATE ROUTE 35 STE 102A
RED BANK NJ
07701-5919
US

IV. Provider business mailing address

13 CHAPMAN TER
MIDDLETOWN NJ
07748-1566
US

V. Phone/Fax

Practice location:
  • Phone: 347-552-2542
  • Fax:
Mailing address:
  • Phone: 347-552-2542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DENISE BALACICH
Title or Position: OPTOMETRIST
Credential: OD
Phone: 347-552-2542