Healthcare Provider Details
I. General information
NPI: 1578655189
Provider Name (Legal Business Name): MORGANSTEIN EYE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2006
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5618 BERGENLINE AVE
WEST NEW YORK NJ
07093-1232
US
IV. Provider business mailing address
5618 BERGENLINE AVE
WEST NEW YORK NJ
07093-1232
US
V. Phone/Fax
- Phone: 201-867-2942
- Fax: 201-867-1777
- Phone: 201-867-2942
- Fax: 201-867-1777
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | OA 5282 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
RICHARD
MORGANSTEIN
Title or Position: OWNER
Credential: O.D.
Phone: 201-867-2942