Healthcare Provider Details

I. General information

NPI: 1275813230
Provider Name (Legal Business Name): NEW JERSEY CENTER FOR CORNEA AND REFRACTIVE SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2011
Last Update Date: 08/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 PROSPECT AVE
WEST ORANGE NJ
07052-4197
US

IV. Provider business mailing address

485 ROUTE 1 S
ISELIN NJ
08830-3009
US

V. Phone/Fax

Practice location:
  • Phone: 973-325-3475
  • Fax: 973-325-3478
Mailing address:
  • Phone: 732-750-0400
  • Fax: 732-510-2544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER QUINN
Title or Position: PRESIDENT
Credential: OD
Phone: 732-750-0400