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General NPI Number Information
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NPI Number | 1801344387
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Entity Type | Organization
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Legal Business Name | THE EYE HEALTH GROUP, LLC
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 255 HIGHWAY 35 NORTH
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City | EATONTOWN
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State | NJ
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Zip | 07724-2808
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Country | US
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Telephone | 732-389-3512
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Fax | 862-930-4477
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Provider Business Mailing Address
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Address Line | 1278 HOOPER AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08753-3343
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Country | US
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Telephone | 732-505-0533
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Fax | 862-930-4477
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL J IULIANO
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Credential | OD
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Telephone | 732-505-0533
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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 | 27OA00501000
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License Number State | NJ
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