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General NPI Number Information
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NPI Number | 1770667610
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Entity Type | Organization
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Legal Business Name | PM OPTICAL
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 515 ROUTE 73 S
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City | MARLTON
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State | NJ
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Zip | 08053-9661
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Country | US
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Telephone | 856-983-2666
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Fax | 856-983-7134
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Provider Business Mailing Address
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Address Line | 515 ROUTE 73 S
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City | MARLTON
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State | NJ
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Zip | 08053-9661
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Country | US
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Telephone | 856-983-2666
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Fax | 856-983-7134
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Authorized Official
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Title or Position | PRES
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Name | MR. JEFFREY PONT
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Credential |
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Telephone | 856-983-2666
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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 | D1321
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | D1321
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License Number State | NJ
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