1154349793 NPI number — ATLANTIC CUMBERLAND EYE ASSOCIATES

Table of content: (NPI 1154349793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154349793 NPI number — ATLANTIC CUMBERLAND EYE ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTIC CUMBERLAND EYE ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154349793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2020 NEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-927-2020
Provider Business Mailing Address Fax Number:
609-926-7616

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2020 NEW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-927-2020
Provider Business Practice Location Address Fax Number:
609-926-7616
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
VICTORIA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
609-927-2020

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  27OM00013700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 25MA06345500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0080580000 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0045402 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1070734 . This is a "HORIZON NEW JERSEY HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 13738 . This is a "SPECTERA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 311078 . This is a "NVA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0099937 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 38180 . This is a "DAVIS VISION" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: CB7269 . This is a "RAILROAD TRAVELERS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com