Provider Demographics
NPI:1215333968
Name:EYEGLASS CORNER, LLC
Entity type:Organization
Organization Name:EYEGLASS CORNER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:D'AMATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS
Authorized Official - Phone:973-337-8565
Mailing Address - Street 1:199 BROAD ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2635
Mailing Address - Country:US
Mailing Address - Phone:973-337-8565
Mailing Address - Fax:
Practice Address - Street 1:199 BROAD ST STE 2B
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2635
Practice Address - Country:US
Practice Address - Phone:973-337-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies