MEDICARE: STANLEY ANTON P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	27OM00088100	NJ

General Provider Information

NPI Number	:	1093009615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANLEY ANTON P.A.

Provider Business Mailing Address
First Line	:	565 HOMER TER
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-7322
Country	:	US
Telephone Number	:	908-687-0535
Fax Number	:

Provider Business Practice Location Address
First Line	:	565 HOMER TERRACE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083
Country	:	US
Telephone Number	:	908-687-0535
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. STANLEY FRANCIS ANTON
Credential	:	O.D.
Telephone Number	:	908-687-0535

Provider Enumeration Date	:	05/31/2011
Last Update Date	:	05/31/2011

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