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General NPI Number Information
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NPI Number | 1073946695
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Entity Type | Organization
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Legal Business Name | NJ OCULOPLASTIC CONSULTANTS, LLC
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Dates
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Enumeration Date | 08/19/2013
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 95 MADISON AVE SUITE 110
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6092
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Country | US
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Telephone | 973-540-1223
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Fax |
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Provider Business Mailing Address
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Address Line | 95 MADISON AVE SUITE 110
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6092
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Country | US
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Telephone | 973-540-1223
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEXANDRA L BRAUNSTEIN
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Credential | MD
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Telephone | 617-784-9800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA09264000
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License Number State | NJ
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