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General NPI Number Information
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NPI Number | 1962521252
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Entity Type | Organization
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Legal Business Name | BRUNSWICK EYE ASSOCIATES
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 317 CLEVELAND AVE
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City | HIGHLAND PARK
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State | NJ
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Zip | 08904-1817
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Country | US
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Telephone | 732-565-1075
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Fax | 732-565-1076
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Provider Business Mailing Address
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Address Line | 317 CLEVELAND AVE
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City | HIGHLAND PARK
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State | NJ
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Zip | 08904-1817
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Country | US
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Telephone | 732-565-1075
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Fax | 732-565-1076
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Authorized Official
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Title or Position | OPTICIAN
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Name | MS. DONNA COLEMAN
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Credential |
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Telephone | 732-565-1075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 31TD00344800
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License Number State | NJ
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