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General NPI Number Information
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NPI Number | 1043644529
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Entity Type | Organization
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Legal Business Name | DR. EYEBALLS, PC
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 279 FERRY ST
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City | NEWARK
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State | NJ
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Zip | 07105-3400
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Country | US
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Telephone | 973-344-2212
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Fax | 973-344-4651
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Provider Business Mailing Address
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Address Line | 48 LILAC DR
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City | LEBANON
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State | NJ
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Zip | 08833-3035
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEFANIE NAUMOVITZ
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Credential |
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Telephone | 908-894-4770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00645800
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License Number State | NJ
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