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General NPI Number Information
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NPI Number | 1245315969
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Entity Type | Organization
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Legal Business Name | BRIGANTINE EYE CARE CENTER
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/02/2010
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Provider Practice Location Address
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Address Line | 4274 HARBOUR BEACH BLVD
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City | BRIGANTINE
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State | NJ
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Zip | 08203-1362
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Country | US
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Telephone | 609-266-8000
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Fax | 609-266-9555
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Provider Business Mailing Address
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Address Line | 4274 HARBOUR BEACH BLVD
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City | BRIGANTINE
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State | NJ
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Zip | 08203-1362
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Country | US
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Telephone | 609-266-8000
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Fax | 609-266-9555
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | EUGENE DIMARCO
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Credential | DO
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Telephone | 609-266-8000
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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 | MB54894
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License Number State | NJ
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