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General NPI Number Information
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NPI Number | 1073612149
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Entity Type | Organization
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Legal Business Name | UNIVERSITY CHILDREN'S EYE CENTER, PC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 4 CORNWALL CT
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3331
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Country | US
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Telephone | 732-613-9191
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Fax | 732-613-1139
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Provider Business Mailing Address
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Address Line | 4 CORNWALL CT
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3331
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Country | US
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Telephone | 732-613-9191
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Fax | 732-613-1139
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. J MARK ENGEL
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Credential |
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Telephone | 732-613-9191
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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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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number |
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License Number State |
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