Organization
VISION SOURCE OF MT OLIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J SIEGEL OD (PRESIDENT)
(862) 258-3200
Entity
Organization
Contact information
Practice address
135 ROUTE 46 EAST, UNIT E, BUDD LAKE, NJ 07828
(862) 258-3200
Mailing address
135 ROUTE 46 EAST, UNIT E, BUDD LAKE, NJ 07828
(862) 258-3200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00511800
NJ
Other
Enumeration date
11/08/2012
Last updated
11/15/2012
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