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General NPI Number Information
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NPI Number | 1245409945
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Entity Type | Organization
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Legal Business Name | MERCER EYE ASSOCIATES PA
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 123 FRANKLIN CORNER RD SUITE 207
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2526
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Country | US
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Telephone | 609-896-1944
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Fax | 609-896-7052
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Provider Business Mailing Address
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Address Line | 123 FRANKLIN CORNER RD SUITE 207
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2526
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Country | US
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Telephone | 609-896-1944
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Fax | 609-896-7052
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Authorized Official
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Title or Position | PHYSICIAN
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Name | STEVEN PAUL ELLIS
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Credential | MD
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Telephone | 609-450-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | TD00222200
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License Number State | NJ
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