Provider Demographics
NPI:1730338914
Name:COMPREHENSIVE EYE CARE PROFESSIONALS LLC
Entity type:Organization
Organization Name:COMPREHENSIVE EYE CARE PROFESSIONALS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:MILSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:917-660-3091
Mailing Address - Street 1:73 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081
Mailing Address - Country:US
Mailing Address - Phone:732-202-0393
Mailing Address - Fax:
Practice Address - Street 1:1 SPRING ST
Practice Address - Street 2:UNIT 101
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2276
Practice Address - Country:US
Practice Address - Phone:732-202-0393
Practice Address - Fax:732-909-2147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00614800152W00000X
NYTUV007285152W00000X
NJ27OM00068900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ134838Medicare PIN