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Contact Information

PEDIATRIC OPHTHALMOLOGY OF NJ, P.C.
57 WILLOWBROOK BLVD
SUITE 411
WAYNE, NJ07470-7047
 Phone: 973-256-4111
 Fax: 973-256-3719
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Pediatric Ophthalmology and Strabismus Specialist

207WX0110X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for PEDIATRIC OPHTHALMOLOGY OF NJ, P.C.

NPI # 1164460218
LBN Legal business name PEDIATRIC OPHTHALMOLOGY OF NJ, P.C.
Authorized official KEVIN MICKEY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/02/2006
Last updated 04/20/2020 - About 6 years ago
Identifiers
NJ Medicaid 8550204
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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