Provider Demographics
NPI:1306876156
Name:CAMDEN EYECARE, P.A.
Entity type:Organization
Organization Name:CAMDEN EYECARE, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESISENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LAVESON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-541-6131
Mailing Address - Street 1:508 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1250
Mailing Address - Country:US
Mailing Address - Phone:856-541-6131
Mailing Address - Fax:856-541-0241
Practice Address - Street 1:508 S BROADWAY
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1250
Practice Address - Country:US
Practice Address - Phone:856-541-6131
Practice Address - Fax:856-541-0241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00Q276201332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier