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General NPI Number Information
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NPI Number | 1477060267
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Entity Type | Organization
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Legal Business Name | MONTENARE EYE CARE & VISION THERAPY LLC
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 541 CEDAR HILL AVE STE H
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City | WYCKOFF
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State | NJ
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Zip | 07481-2150
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Country | US
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Telephone | 631-455-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 541 CEDAR HILL AVE
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City | WYCKOFF
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State | NJ
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Zip | 07481-2150
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Country | US
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Telephone | 201-857-5111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL MONTENARE
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Credential |
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Telephone | 201-857-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 27OA00641300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00641300
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License Number State | NJ
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