MEDICARE: SUMMIT EYE & OPTICAL LLC

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	27OA00419700	NJ

General Provider Information

NPI Number	:	1184916587
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT EYE & OPTICAL LLC

Provider Business Mailing Address
First Line	:	323 SPRINGFIELD AVE
Second Line	:
City	:	SUMMIT
State	:	NJ
Zip	:	07901-3626
Country	:	US
Telephone Number	:	908-918-0377
Fax Number	:	908-918-0109

Provider Business Practice Location Address
First Line	:	323 SPRINGFIELD AVE
Second Line	:
City	:	SUMMIT
State	:	NJ
Zip	:	07901-3626
Country	:	US
Telephone Number	:	908-918-0377
Fax Number	:	908-918-0109

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONALD J SEILER
Credential	:	OD
Telephone Number	:	908-918-0377

Provider Enumeration Date	:	05/04/2011
Last Update Date	:	02/25/2014

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Directions to “SUMMIT EYE & OPTICAL LLC ” Practice Location

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