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General NPI Number Information
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NPI Number | 1902972698
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Entity Type | Organization
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Legal Business Name | THE EYEXAM GROUP OF EAST BRUNSWICK
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 10/06/2007
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Provider Practice Location Address
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Address Line | 434 STATE ROUTE 18
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2374
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Country | US
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Telephone | 732-613-1500
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Fax | 732-238-4357
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Provider Business Mailing Address
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Address Line | 434 STATE ROUTE 18
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2374
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Country | US
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Telephone | 732-613-1500
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Fax | 732-238-4357
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFERY STUART NEUSS
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Credential | O.D.
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Telephone | 732-613-1500
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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 | 27OA00299600
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License Number State | NJ
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