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General NPI Number Information
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NPI Number | 1447319579
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Entity Type | Organization
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Legal Business Name | PHILLIPS EYE CONSULTANTS
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 1440 HOW LN SUITE 2B
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-4600
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Country | US
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Telephone | 732-249-6164
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Fax | 732-418-1976
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Provider Business Mailing Address
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Address Line | PO BOX 7184
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-7184
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Country | US
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Telephone | 732-249-6164
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Fax | 732-418-1976
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FAY LOLITA BENNETT
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Credential | MD
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Telephone | 732-249-6164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number |
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License Number State |
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