Edward J Moylan Od Pc

NPI 1043408958 - Optometrist - 152W00000X

NPI Details
NPI 1043408958
Enumeration Date 10/05/2007
Last Updated 11/13/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name EDWARD J EDWARD
Position OPTOMETRIST
Phone (631) 642-2020
Fax (631) 642-3938
Practice Location
500 HALLOCK AVE
PORT JEFFERSON STATION NY, 11776-1200, US
Phone (631) 642-2020
Fax (631) 642-3938
Business Location
500 HALLOCK AVE
PORT JEFFERSON STATION NY, 11776-1200, US
Phone (631) 642-2020
Fax (631) 642-3938
Toxanomy
Taxonomy Code 152W00000X
License State New York
License Number TUV004922-1
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According to our database, Edward J Moylan Od Pc NPI is 1043408958, taxonomy code is 152W00000X and license number is TUV004922-1, license state is located at New York. Edward J Moylan Od Pc physically located at 500 Hallock Ave, Port Jefferson Station NY, 11776-1200. NPI Number 1033115704 has the healthcare provider type.

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1043408958 NPI number is provided on an as is basis without warranty of any kind. 1043408958 is maintained by the National Plan & Provider Enumeration System. The contents of Edward J Moylan Od Pc are for informational purposes only.