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General NPI Number Information
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NPI Number | 1699941666
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Entity Type | Organization
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Legal Business Name | EYE ASSOCIATES OF MONMOUTH, LLC
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 410 ROUTE 34 N STE 218
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City | COLTS NECK
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State | NJ
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Zip | 07722-1017
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Country | US
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Telephone | 732-431-6688
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Fax | 732-431-2552
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Provider Business Mailing Address
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Address Line | 410 ROUTE 34 N STE 218
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City | COLTS NECK
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State | NJ
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Zip | 07722-1017
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Country | US
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Telephone | 732-431-6688
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Fax | 732-431-2552
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | DR. JOHN M GHOBRIAL
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Credential | M.D.
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Telephone | 732-431-6688
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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 | MA71507
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License Number State | NJ
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