Organization
CUSTOM EYES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE L GONCHAR (PRESIDENT)
(732) 613-3937
Entity
Organization
Contact information
Practice address
162 SUMMERHILL RD, EAST BRUNSWICK, NJ 08816-4929
(732) 613-3937
(732) 613-3969
Mailing address
162 SUMMERHILL RD, EAST BRUNSWICK, NJ 08816-4929
(732) 613-3937
(732) 613-3969
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
31TD00135400
NJ
Other
Enumeration date
01/03/2007
Last updated
03/18/2008
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