Healthcare Provider Details

I. General information

NPI: 1023204336
Provider Name (Legal Business Name): THE EYE CENTRE LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 ELIZABETH ST SUITE 100
RIVER EDGE NJ
07661-1933
US

IV. Provider business mailing address

10 ELIZABETH ST SUITE 100
RIVER EDGE NJ
07661-1933
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-4412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberMA06926700
License Number StateNJ

VIII. Authorized Official

Name: LISA M HIGGINS
Title or Position: DOCTOR
Credential:
Phone: 201-488-4412