Organization
EDISON OPHTHALMOLOGY ASSOCIATES L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C PARK MD (PRESIDENT)
(908) 822-0070
Entity
Organization
Contact information
Practice address
2177 OAK TREE RD, #203, EDISON, NJ 08820-1082
(908) 822-0070
Mailing address
2177 OAK TREE RD, #203, EDISON, NJ 08820-1082
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA07540000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2334336000
AMERIHEALTH HMO ID
—
Enumeration date
06/03/2006
Last updated
03/06/2023
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