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General NPI Number Information
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NPI Number | 1558071530
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Entity Type | Organization
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Legal Business Name | AMICO EYE GROUP LLC
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 1808 LONG BEACH BLVD
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City | SHIP BOTTOM
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State | NJ
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Zip | 08008-4443
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Country | US
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Telephone | 609-494-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 1808 LONG BEACH BLVD
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City | SHIP BOTTOM
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State | NJ
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Zip | 08008-4443
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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 | OPTOMETRIST
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Name | ASHLEY MARIE AMICO
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Credential | OD
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Telephone | 973-768-4714
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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 |
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