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General NPI Number Information
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NPI Number | 1063036564
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Entity Type | Organization
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Legal Business Name | SENIOR EYE CARE PC
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Dates
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Enumeration Date | 06/01/2020
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Last Update Date | 06/01/2020
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Provider Practice Location Address
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Address Line | 6 CHESLEY CT
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City | MORGANVILLE
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State | NJ
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Zip | 07751-1320
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Country | US
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Telephone | 732-208-2387
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Fax |
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Provider Business Mailing Address
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Address Line | 205 ROUTE 9 N STE 24
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City | FREEHOLD
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State | NJ
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Zip | 07728-8561
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Country | US
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Telephone | 732-255-2252
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Fax | 848-444-9801
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RHONDA RAVITZ
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Credential | OD
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Telephone | 732-208-2387
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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 |
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License Number State |
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