Provider Demographics
NPI:1861785701
Name:DR. MO'S EYE CARE
Entity type:Organization
Organization Name:DR. MO'S EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLOCK-HEROLD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-577-3471
Mailing Address - Street 1:2433 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:PA
Mailing Address - Zip Code:19001-4206
Mailing Address - Country:US
Mailing Address - Phone:856-577-3471
Mailing Address - Fax:215-884-0818
Practice Address - Street 1:2000 CLEMENTS BRIDGE RD STE 116
Practice Address - Street 2:
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-2016
Practice Address - Country:US
Practice Address - Phone:856-384-2501
Practice Address - Fax:856-384-2503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty