Provider Demographics
NPI:1962521252
Name:BRUNSWICK EYE ASSOCIATES
Entity type:Organization
Organization Name:BRUNSWICK EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-565-1075
Mailing Address - Street 1:317 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1817
Mailing Address - Country:US
Mailing Address - Phone:732-565-1075
Mailing Address - Fax:732-565-1076
Practice Address - Street 1:317 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1817
Practice Address - Country:US
Practice Address - Phone:732-565-1075
Practice Address - Fax:732-565-1076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00344800156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty