| Angel Eyecare Llc | |
|
1 Teterboro Landing Dr Inside Walmart Vision Center Teterboro NJ 07608 | |
| (201) 375-4005 | |
| Not Available |
| Full Name | Angel Eyecare Llc |
|---|---|
| Speciality | Optometrist |
| Location | 1 Teterboro Landing Dr, Teterboro, New Jersey |
| Authorized Official Name and Position | Shirley G Angel (OWNER) |
| Authorized Official Contact | 9733923182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Eyecare Llc 69 Center St Belleville NJ 07109-1705 Ph: (973) 392-3182 | Angel Eyecare Llc 1 Teterboro Landing Dr Inside Walmart Vision Center Teterboro NJ 07608 Ph: (201) 375-4005 |
| NPI Number | 1467903880 |
|---|---|
| Provider Enumeration Date | 10/20/2016 |
| Last Update Date | 11/15/2018 |
| Medicare PECOS PAC ID | 8820373889 |
|---|---|
| Medicare Enrollment ID | O20170315000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467903880 | NPI | - | NPPES |
| 0519081 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 152W00000X | Optometrist | 27OA00595000 (New Jersey) | Primary |
| Provider Name | Shirley Angel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144411455 PECOS PAC ID: 9739464793 Enrollment ID: I20170315000138 |