Provider Demographics
NPI:1386695393
Name:MONMOUTH VISION ASSOCIATES PC
Entity type:Organization
Organization Name:MONMOUTH VISION ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:LINKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-617-1717
Mailing Address - Street 1:50 ROUTE 9 N STE 206
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1558
Mailing Address - Country:US
Mailing Address - Phone:732-617-1717
Mailing Address - Fax:732-617-1313
Practice Address - Street 1:50 ROUTE 9 N STE 206
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1558
Practice Address - Country:US
Practice Address - Phone:732-617-1717
Practice Address - Fax:732-617-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00454300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8652007Medicaid
NJ4315540001Medicare NSC
NJ051903Medicare ID - Type Unspecified