Organization
OPHTHALMOLOGY OF MONTCLAIR LIMITED LIABILITY COMPANY
Active
Organization
OPHTHALMOLOGY OF MONTCLAIR LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHRYN PHYLLIS CHILDS MD (OWNER)
(973) 509-6039
Entity
Organization
Contact information
Practice address
33 N FULLERTON AVE, 1ST FLOOR, MONTCLAIR, NJ 07042-3412
(973) 509-6039
(973) 509-6069
Mailing address
33 N FULLERTON AVE, 1ST FLOOR, MONTCLAIR, NJ 07042-3412
(973) 509-6039
(973) 509-6069
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA07491800
NJ
Other
Enumeration date
02/08/2007
Last updated
08/27/2007
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