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General NPI Number Information
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NPI Number | 1790702710
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Entity Type | Organization
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Legal Business Name | ROBERT J MANOLI OD AND ASSOCIATES PC
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 05/31/2011
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Provider Practice Location Address
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Address Line | 3159 RT. 9 SOUTH WALMART VISION CENTER
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City | RIO GRANDE
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State | NJ
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Zip | 08242-1012
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Country | US
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Telephone | 609-465-7552
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Fax | 609-465-7704
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Provider Business Mailing Address
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Address Line | 3159 RT. 9 SOUTH
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City | RIO GRANDE
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State | NJ
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Zip | 08242-1012
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Country | US
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Telephone | 609-465-7552
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Fax | 609-465-7704
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT JOSEPH MANOLI
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Credential | OD
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Telephone | 609-465-7552
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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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