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Organization

BARRY J. EDISON D.O. P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BARRY J. EDISON D.O. (OWNER)
(732) 542-0300
Entity
Organization

Contact information

Practice address
10 INDUSTRIAL WAY E, SUITE 102, EATONTOWN, NJ 07724-3332
(732) 542-0300
(732) 935-0533
Mailing address
10 INDUSTRIAL WAY E, SUITE 102, EATONTOWN, NJ 07724-3332
(732) 542-0300
(732) 935-0533

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary
MB72146
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DF2658
RAILROAD MEDICARE
NJ
Enumeration date
07/14/2006
Last updated
11/17/2011
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