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General NPI Number Information
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NPI Number | 1255723128
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Entity Type | Organization
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Legal Business Name | THE EYE DOCTOR, LLC
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Dates
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Enumeration Date | 03/02/2015
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 326 W MAIN ST
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City | FREEHOLD
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State | NJ
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Zip | 07728-2524
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Country | US
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Telephone | 732-677-3700
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Fax | 732-677-3701
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Provider Business Mailing Address
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Address Line | 326 W MAIN ST
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City | FREEHOLD
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State | NJ
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Zip | 07728-2524
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Country | US
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Telephone | 732-677-3700
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Fax | 732-677-3701
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. ROBIN GREENFIELD
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Credential | O.D.
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Telephone | 732-306-5656
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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 | 27OA00606400
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License Number State | NJ
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