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125 Washington Ave, Dumont, NJ 07628-3066 | |
(201) 385-3055 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 125 Washington Ave, Dumont, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1043365182 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 27OA00604000 (New Jersey) | Primary |
Provider Name | Epifanio I Sunga |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1457362055 PECOS PAC ID: 8426055468 Enrollment ID: I20061103000341 |
Mailing Address | Practice Location Address |
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125 Washington Ave, Dumont, NJ 07628-3066 Ph: (201) 385-3055 | 125 Washington Ave, Dumont, NJ 07628-3066 Ph: (201) 385-3055 |