Epifanio I Sunga OD PA
Organization Active NPI Optometrist · Dumont, NJ
NPI 1043365182 · NPPES record last updated Dec 29, 2008
Key facts
- NPI
- 1043365182
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 27OA00604000 (NJ)
- Legal business name
- EPIFANIO I SUNGA OD PA
- Practice address
- 125 Washington Ave
Dumont, NJ 07628-3066 - Phone
- (201) 385-3055
- NPI assigned
- Jan 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Epifanio I. Sunga, O.D.
- Title
- Optometrist
- Phone
- (201) 244-6563
Practitioners 2
-
Epifanio I Sunga, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070328000589 | NJ | Part B Supplier - Clinic/Group Practice | 6204930449 |
Receives reassigned benefits from 1 practitioner Practice locations: Dumont, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 27OA00604000 | NJ | Yes |
Addresses
Primary practice location
125 Washington Ave
Dumont, NJ 07628-3066
Mailing address
125 Washington Ave
Dumont, NJ 07628-3066
Phone (201) 385-3055
Other names
- Dumont Eye Care
Other providers in Dumont, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.