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General NPI Number Information
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NPI Number | 1588803084
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Entity Type | Organization
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Legal Business Name | B & B EYE CARE LLC
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Dates
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Enumeration Date | 02/07/2009
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Last Update Date | 02/07/2009
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Provider Practice Location Address
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Address Line | 831 ROUTE 10 STE 22 PINE PLAZA
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City | WHIPPANY
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State | NJ
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Zip | 07981-1154
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Country | US
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Telephone | 973-769-2470
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Fax | 973-633-1639
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Provider Business Mailing Address
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Address Line | 29 VERKADE DR
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City | WAYNE
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State | NJ
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Zip | 07470-8217
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Country | US
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Telephone | 973-769-2470
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Fax | 973-633-1639
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Authorized Official
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Title or Position | DIRECTOR/SOLE MEMBER
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Name | DR. BERNARD GUTMAN
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Credential | O.D.
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Telephone | 973-769-2470
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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 | 270A00376100
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License Number State | NJ
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