Organization
VISIONARY EYE CARE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK YOUNG O.D. (PRESIDENT)
(856) 359-3654
Entity
Organization
Contact information
Practice address
100 CENTERTON RD, MOUNT LAUREL, NJ 08054-6103
(856) 359-3654
(856) 359-3680
Mailing address
100 CENTERTON RD, MOUNT LAUREL, NJ 08054-6103
(856) 359-3654
(856) 359-3680
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00554300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104339
MEDICARE PTAN
NJ
Enumeration date
07/18/2006
Last updated
02/17/2022
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