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General NPI Number Information
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NPI Number | 1760412514
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Entity Type | Organization
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Legal Business Name | CHERRY HILL EYECARE, P.A.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1188 ROUTE 70 EAST
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2131
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Country | US
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Telephone | 856-795-6444
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Fax | 856-795-2828
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Provider Business Mailing Address
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Address Line | 1188 ROUTE 70 EAST
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2131
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Country | US
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Telephone | 856-795-6444
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Fax | 856-795-2828
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Authorized Official
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Title or Position | SECRETARY TREASURER
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Name | DR. JOEL WILLIAM LAVESON
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Credential | O.D.
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Telephone | 856-795-6444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OA00276200
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License Number State | NJ
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