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General NPI Number Information
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NPI Number | 1326246919
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY EYE CENTER, INC.
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 400 CHAMBERS AVE
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City | CAMDEN
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State | NJ
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Zip | 08103-1405
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Country | US
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Telephone | 856-365-1811
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Fax | 856-365-1379
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Provider Business Mailing Address
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Address Line | 400 CHAMBERS AVE
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City | CAMDEN
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State | NJ
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Zip | 08103-1405
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Country | US
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Telephone | 856-365-1811
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Fax | 856-365-1379
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MS. DEBORAH DEMILIO
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Credential |
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Telephone | 856-365-2420
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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 |
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License Number State | NJ
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