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General NPI Number Information
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NPI Number | 1528152964
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Entity Type | Organization
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Legal Business Name | THE CORNEA AND LASER EYE INSTITUTE, P.A.
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/19/2009
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Provider Practice Location Address
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Address Line | 300 FRANK W BURR BLVD GLENPOINTE CENTER EAST
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City | TEANECK
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State | NJ
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Zip | 07666
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Country | US
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Telephone | 201-692-9434
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Fax | 201-692-9646
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Provider Business Mailing Address
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Address Line | 300 FRANK W BURR BLVD GLENPOINTE CENTER EAST
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City | TEANECK
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State | NJ
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Zip | 07666
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Country | US
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Telephone | 201-692-9434
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Fax | 201-692-9646
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MS. STACEY M. PARK
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Credential |
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Telephone | 201-692-9434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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