Organization
PROVISION FAMILY EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIKA WYSOCZANSKA OD (OWNER)
(609) 723-8957
Entity
Organization
Contact information
Practice address
3452 BROIDY RD, MCGUIRE AFB, TRENTON, NJ 08641-5305
(609) 723-8957
Mailing address
3452 BROIDY RD, MCGUIRE AFB, TRENTON, NJ 08641-5305
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00611200
NJ
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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