Monika Wysoczanska, OD | |
357 Us Highway 9, Manalapan, NJ 07726-3284 | |
(732) 972-2221 | |
Not Available |
Full Name | Monika Wysoczanska |
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Gender | Female |
Speciality | Optometrist |
Location | 357 Us Highway 9, Manalapan, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376737924 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 27OA00611200 (New Jersey) | Primary |
Provider Name | Provision Family Eye Care |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1407397011 PECOS PAC ID: 5395020150 Enrollment ID: O20170320000554 |
Mailing Address | Practice Location Address |
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Monika Wysoczanska, OD 22 Sunset Dr, Port Reading, NJ 07064-1426 Ph: () - | Monika Wysoczanska, OD 357 Us Highway 9, Manalapan, NJ 07726-3284 Ph: (732) 972-2221 |
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