Organization
MIDATLANTIC OPHTHALMOLOGY GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN CMIELEWSKI (ADMINISTRATOR)
(732) 741-0858
Entity
Organization
Contact information
Practice address
70 E FRONT ST, RED BANK, NJ 07701-1851
(732) 741-0858
(732) 219-0180
Mailing address
70 E FRONT ST, RED BANK, NJ 07701-1851
(732) 741-0858
(732) 219-0180
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4555708
—
NJ
Enumeration date
01/18/2006
Last updated
05/17/2010
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