Organization
JOHN D WILGUCKI DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D WILGUCKI D.O. (OPHTHALMOLOGIST)
(732) 388-3030
Entity
Organization
Contact information
Practice address
1500 SAINT GEORGES AVE, AVENEL, NJ 07001-1000
(732) 388-3030
Mailing address
1500 SAINT GEORGES AVE, AVENEL, NJ 07001-1000
(732) 388-3030
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MB56000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123015
AETNA
—
01
—
1457418642
HEALTHNET
—
05
—
5805802
—
NJ
Enumeration date
02/19/2008
Last updated
05/24/2011
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