Provider Demographics
NPI:1366578700
Name:NJ EYES, INC.
Entity type:Organization
Organization Name:NJ EYES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAYLES
Authorized Official - Suffix:
Authorized Official - Credentials:LICENCD OPTICIAN
Authorized Official - Phone:732-840-0607
Mailing Address - Street 1:1930 ROUTE 88
Mailing Address - Street 2:LAUREL SQUARE
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3153
Mailing Address - Country:US
Mailing Address - Phone:732-840-0606
Mailing Address - Fax:
Practice Address - Street 1:1930 ROUTE 88
Practice Address - Street 2:LAUREL SQUARE
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3153
Practice Address - Country:US
Practice Address - Phone:732-840-0606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD1520332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site