Provider Demographics
NPI:1104050079
Name:DMA EYE ASSOCIATES, LLC
Entity type:Organization
Organization Name:DMA EYE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-687-2244
Mailing Address - Street 1:2565 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5613
Mailing Address - Country:US
Mailing Address - Phone:908-687-2244
Mailing Address - Fax:908-687-7344
Practice Address - Street 1:2565 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5613
Practice Address - Country:US
Practice Address - Phone:908-687-2244
Practice Address - Fax:908-687-7344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00512000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU42084Medicare UPIN
NJ4358370001Medicare NSC
NJ179910Medicare PIN