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General NPI Number Information
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NPI Number | 1982751939
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Entity Type | Organization
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Legal Business Name | MANAHAWKIN VISION INC.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 733 ROUTE 72 W
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-2839
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Country | US
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Telephone | 609-597-0250
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Fax | 609-597-0252
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Provider Business Mailing Address
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Address Line | 733 ROUTE 72 W
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-2839
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Country | US
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Telephone | 609-597-0250
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Fax | 609-597-0252
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DARLEEN MCGLAUGHLIN
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Credential |
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Telephone | 609-597-0250
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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 | 27OA00427900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00426400
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License Number State | NJ
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