Individual
DR. ALFONSO C. BULLOCK II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
261A BROAD AVE., PALISADES PARK, NJ 07650
(201) 944-3068
Mailing address
257B 5TH ST, PALISADES PARK, NJ 07650-2034
(201) 947-6590
(631) 666-1984
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00599000
NJ
152W00000X
Optometrist
TUV-006870-1
NY
Other
Enumeration date
07/06/2006
Last updated
07/08/2007
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