Provider Demographics
NPI:1154349793
Name:ATLANTIC CUMBERLAND EYE ASSOCIATES
Entity type:Organization
Organization Name:ATLANTIC CUMBERLAND EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-927-2020
Mailing Address - Street 1:2020 NEW RD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221
Mailing Address - Country:US
Mailing Address - Phone:609-927-2020
Mailing Address - Fax:609-926-7616
Practice Address - Street 1:2020 NEW RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221
Practice Address - Country:US
Practice Address - Phone:609-927-2020
Practice Address - Fax:609-926-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00013700152W00000X
NJ25MA06345500207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0080580000OtherAMERIHEALTH
NJ0045402OtherAETNA
NJ1070734OtherHORIZON NEW JERSEY HEALTH
NJ13738OtherSPECTERA
NJ311078OtherNVA
NJ0099937Medicaid
NJ38180OtherDAVIS VISION
NJCB7269OtherRAILROAD TRAVELERS
NJ0080580000OtherAMERIHEALTH
NJ13738OtherSPECTERA
NJAT113941Medicare PIN
NJCB7269OtherRAILROAD TRAVELERS