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General NPI Number Information
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NPI Number | 1225171150
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Entity Type | Organization
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Legal Business Name | EYE INSTITUTE OF CENTRAL NEW JERSEY, PC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 03/27/2022
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Provider Practice Location Address
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Address Line | 1130 RARITAN RD STE 1
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City | CRANFORD
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State | NJ
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Zip | 07016-3378
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Country | US
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Telephone | 908-325-6227
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Fax | 908-325-3306
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Provider Business Mailing Address
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Address Line | 1130 RARITAN RD STE 1
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City | CRANFORD
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State | NJ
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Zip | 07016-3378
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Country | US
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Telephone | 908-325-6227
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Fax | 908-325-3306
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS CONRAD AIELLO
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Credential | MD
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Telephone | 973-632-0323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA07826300
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License Number State | NJ
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