Organization
MONTGOMERY EYE CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY ELLEN BONAME O.D. (OPTOMETRIC PHYSICIAN/PRESIDENT)
(609) 279-0005
Entity
Organization
Contact information
Practice address
1325 ROUTE 206, SUITE 24, SKILLMAN, NJ 08558-1922
(609) 279-0005
(609) 279-0004
Mailing address
1325 ROUTE 206, SUITE 24, SKILLMAN, NJ 08558-1922
(609) 279-0005
(609) 279-0004
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
27OA00529800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093045437
NPI (GROUP)
NJ
01
—
1932132024
NPI (INDIVIDUAL)
NJ
Enumeration date
01/07/2010
Last updated
04/07/2010
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