Provider Demographics
NPI:1154968386
Name:BRUNNER EYE CARE
Entity type:Organization
Organization Name:BRUNNER EYE CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SANJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-232-8182
Mailing Address - Street 1:100 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2112
Mailing Address - Country:US
Mailing Address - Phone:908-232-8182
Mailing Address - Fax:
Practice Address - Street 1:100 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2112
Practice Address - Country:US
Practice Address - Phone:908-232-8182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty