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General NPI Number Information
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NPI Number | 1205967973
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Entity Type | Organization
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Legal Business Name | SOMERSET EYE CARE, LLC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 2090 STATE ROUTE 27 SUITE 105
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1142
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Country | US
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Telephone | 732-658-6765
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Fax | 732-568-0041
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Provider Business Mailing Address
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Address Line | 2090 STATE ROUTE 27 SUITE 105
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1142
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Country | US
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Telephone | 732-658-6765
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Fax | 732-568-0041
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JONATHAN IVOR FISHBEIN
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Credential | O.D.
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Telephone | 732-658-6765
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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 | OA5492
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OA5536
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License Number State | NJ
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