| Modern Vue Eyecare | |
|
1508 Willowbrook Mall Wayne NJ 07470 | |
| (973) 256-0060 | |
| Not Available |
| Full Name | Modern Vue Eyecare |
|---|---|
| Speciality | Clinic/Center |
| Location | 1508 Willowbrook Mall, Wayne, New Jersey |
| Authorized Official Name and Position | Mariam Aslami (OPTOMETRIST) |
| Authorized Official Contact | 7066317168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Vue Eyecare 23 Hopper Ln Wayne NJ 07470-4656 Ph: (706) 631-7168 | Modern Vue Eyecare 1508 Willowbrook Mall Wayne NJ 07470 Ph: (973) 256-0060 |
| NPI Number | 1750002069 |
|---|---|
| Provider Enumeration Date | 09/06/2022 |
| Last Update Date | 12/21/2022 |
| Medicare PECOS PAC ID | 3375918493 |
|---|---|
| Medicare Enrollment ID | O20230403002110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750002069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | John J Dzurenda |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740344217 PECOS PAC ID: 4385838598 Enrollment ID: I20101102000400 |
| Provider Name | Mariam Aslami |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205289790 PECOS PAC ID: 0749560944 Enrollment ID: I20230404000346 |
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