Basic Information
| Provider Information | |||||||||
| NPI: | 1760440671 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VINELAND EYE ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2250 ECHELON MALL | ||||||||
| Address2: | |||||||||
| City: | VOORHEES | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080431943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567726331 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3849 S DELSEA DR | ||||||||
| Address2: | C-1 | ||||||||
| City: | VINELAND | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8568258999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | STEIN | ||||||||
| AuthorizedOfficialFirstName: | DALE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8567726331 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.