Mt Holly Eye Physicians & Surgeons

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

MA65455 Issued in NJ

Legal business name

MT HOLLY EYE PHYSICIANS & SURGEONS

Practice address

1613 Route 38
Lumberton, NJ 08048-2921

Phone

(609) 267-5577

Fax

(609) 267-5570

NPI assigned

May 8, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Harry Grossman, MD

Title

Supervisor

Phone

(609) 267-5577

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mt Holly Optical Other name

Tax ID family

Mt Holly Eye Physicians and Surgeons2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mt Holly Eye Physicians and Surgeons

  • Eyewear Supplier
  • Lumberton, NJ
  • NPI 1104097880
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1801009766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482921",
            "telephone_number": "609-267-5577",
            "fax_number": "609-267-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 ROUTE 38",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482921",
            "telephone_number": "609-267-5577",
            "fax_number": "609-267-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT HOLLY EYE PHYSICIANS & SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "609-267-5577",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NJ",
            "license": "MA65455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3099717",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt Holly Optical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dawn Michelle Moleins
• Viqar H Moosavi, DMD
• Matthew Morse, LSW
• Moss Achievement Center, LLC
• Mount Holly Operator LLC
• Mt Holly Eye Physicians & Surgeons Professional Association
• Mt Holly Eye Physicians and Surgeons
• Mt. Holly Family Footcare
• Naomi Myers, LAMFT
• National Mentor Healthcare, LLC

• Eyewear Supplier in Lumberton, NJ
• Providers in Lumberton, NJ by specialty
• Eyewear Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.