Provider Demographics
NPI:1174786743
Name:NEVYAS EYE ASSOCIATES OF NJ PC
Entity type:Organization
Organization Name:NEVYAS EYE ASSOCIATES OF NJ PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEVYAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-668-2935
Mailing Address - Street 1:2 BALA PLZ STE PL33
Mailing Address - Street 2:333 E CITY AVENUE
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1505
Mailing Address - Country:US
Mailing Address - Phone:610-668-2777
Mailing Address - Fax:610-668-1509
Practice Address - Street 1:1001 LINCOLN DR W
Practice Address - Street 2:GREENTREE EXECUTIVE CAMPUS
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1534
Practice Address - Country:US
Practice Address - Phone:856-985-9797
Practice Address - Fax:856-985-1191
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVYAS EYE ASSOCIATES OF NJ PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-03
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical