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General NPI Number Information
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NPI Number | 1114616919
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Entity Type | Organization
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Legal Business Name | BELIGHT EYECARE LLC
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Dates
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Enumeration Date | 05/05/2023
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 543 RIVER RD
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City | EDGEWATER
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State | NJ
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Zip | 07020-1146
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Country | US
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Telephone | 201-402-0255
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Fax |
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Provider Business Mailing Address
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Address Line | 510B LINCOLN ST
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City | PALISADES PARK
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State | NJ
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Zip | 07650-2648
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Country | US
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Telephone | 201-906-9931
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | EUN J YOO
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Credential | OD
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Telephone | 201-906-9931
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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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