Organization
ELLIS' FAMILY EYECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN S ELLIS OD (OWNER)
(609) 294-8144
Entity
Organization
Contact information
Practice address
691 ROUTE 9 S, MILLERS MALL, UNIT 4, LITTLE EGG HARBOR TWP, NJ 08087-4020
(609) 294-8144
(609) 512-5190
Mailing address
691 ROUTE 9 S, MILLERS MALL, UNIT 4, LITTLE EGG HARBOR TWP, NJ 08087-4020
(609) 294-8144
(609) 512-5190
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OA05056
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124542
PTAN
NJ
Enumeration date
01/23/2008
Last updated
02/10/2012
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