Organization
ADVANCED EYECARE OF WASHINGTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GIGETTE COLLAZO HARFST O.D. (CLINICAL DIRECTOR / CEO)
(908) 689-0240
Entity
Organization
Contact information
Practice address
15 W WASHINGTON AVE, WASHINGTON, NJ 07882-1916
(908) 689-0240
(908) 689-0676
Mailing address
15 W WASHINGTON AVE, WASHINGTON, NJ 07882-1916
(908) 689-0240
(908) 689-0676
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA000514000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
313860YT46
MEDICARE GROUP MEMBER PROVIDER NUMBER
NJ
Enumeration date
06/18/2013
Last updated
04/24/2014
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