Provider Demographics
NPI:1174987572
Name:IN FOCUS EYECARE, PA
Entity type:Organization
Organization Name:IN FOCUS EYECARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBIN-SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-981-8000
Mailing Address - Street 1:1100 CENTENNIAL AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4152
Mailing Address - Country:US
Mailing Address - Phone:732-981-8000
Mailing Address - Fax:732-981-8070
Practice Address - Street 1:1100 CENTENNIAL AVE STE 204
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4152
Practice Address - Country:US
Practice Address - Phone:732-981-8000
Practice Address - Fax:732-981-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00591400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ071472Medicare UPIN