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General NPI Number Information
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NPI Number | 1477064905
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Entity Type | Organization
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Legal Business Name | NJ EYE CONSULTANTS
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 02/13/2019
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Provider Practice Location Address
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Address Line | 101 PROSPECT ST STE 102
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5003
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Country | US
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Telephone | 908-309-9862
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 118
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City | OAKHURST
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State | NJ
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Zip | 07755-0118
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID B LEVENTER
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Credential |
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Telephone | 732-571-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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