Provider Demographics
NPI:1548281157
Name:MARLTON EYE ASSOCIATES, PC
Entity type:Organization
Organization Name:MARLTON EYE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:K
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-596-4416
Mailing Address - Street 1:65 PLAZA 70 EAST
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-596-4416
Mailing Address - Fax:856-596-6566
Practice Address - Street 1:65 PLAZA 70 EAST
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-596-4416
Practice Address - Fax:856-596-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1C 0537910001OtherDME
NJ0537910001Medicare NSC
NJ1C 0537910001OtherDME
088241Medicare PIN