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General NPI Number Information
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NPI Number | 1962626937
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Entity Type | Organization
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Legal Business Name | VISION CARE, P.A.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2901 ROUTE 42
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-5111
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Country | US
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Telephone | 856-728-5887
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Fax | 609-877-5970
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Provider Business Mailing Address
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Address Line | 2901 ROUTE 42
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-5111
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Country | US
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Telephone | 856-728-5887
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Fax | 609-877-5970
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Authorized Official
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Title or Position | OWNER
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Name | DR. BURTON M. MARTINIQUE
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Credential | O.D.
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Telephone | 609-877-8550
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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 | 27OA002621
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License Number State | NJ
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