Healthcare Provider Details

I. General information

NPI: 1679673644
Provider Name (Legal Business Name): PRINCETON EYE GROUP,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 01/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 EASTON AVENUE SUITE 50
SOMERSET NJ
08873
US

IV. Provider business mailing address

419 NORTH HARRISON STREET SUITE 104
PRINCETON NJ
08540
US

V. Phone/Fax

Practice location:
  • Phone: 732-565-9550
  • Fax: 732-565-0946
Mailing address:
  • Phone: 609-921-9437
  • Fax: 609-688-9941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN M FELTON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 609-921-9437