Provider Demographics
NPI:1316901978
Name:NEVYAS EYE ASSOCIATES OF NJ PC
Entity type:Organization
Organization Name:NEVYAS EYE ASSOCIATES OF NJ PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEVYAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-668-2777
Mailing Address - Street 1:333 E CITY AVE
Mailing Address - Street 2:2 BALA PLAZA
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1501
Mailing Address - Country:US
Mailing Address - Phone:610-668-2777
Mailing Address - Fax:610-668-0536
Practice Address - Street 1:1001 LINCOLN DR W
Practice Address - Street 2:GREENTREE EXECUTIVE CAMPUS
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1534
Practice Address - Country:US
Practice Address - Phone:856-985-9797
Practice Address - Fax:856-985-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ763317OtherPA BLUE SHIELD
NJ0005942232OtherAETNA PPO
NJ0706610000OtherAMERIHEALTH HMO
NJ483852OtherAETNA HMO
NJ6619509Medicaid
NJ=========OtherCIGNA
NJ6619509Medicaid
NJ=========OtherUNITED HEALTHCARE
NJ=========OtherHORIZON BCBS