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General NPI Number Information
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NPI Number | 1265632251
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Entity Type | Organization
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Legal Business Name | LONG VALLEY EYE CARE, LLC
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 62 E MILL RD C-8
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City | LONG VALLEY
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State | NJ
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Zip | 07853-3118
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Country | US
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Telephone | 908-876-9955
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Fax | 908-876-1055
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Provider Business Mailing Address
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Address Line | 62 E MILL RD C-8
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City | LONG VALLEY
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State | NJ
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Zip | 07853-3118
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Country | US
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Telephone | 908-876-9955
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Fax | 908-876-1055
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER D MOORE
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Credential | OD
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Telephone | 908-876-9955
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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 | 4830
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License Number State | NJ
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