| Organization Name: | MONTGOMERY EYE CARE, P.A. |
| NPI Number: | 1093045437 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY ELLEN BONAME (OPTOMETRIC PHYSICIAN/PRESIDENT) |
| Mailing Address: | 1325 Route 206 Suite 24 Skillman |
| State: | NJ US |
| Postal Code: | 085581922 |
| Phone Number: | 6092790005 |
| Fax Number: | 6092790004 |
| NPI Enumeration Date: | 01/07/2010 |
| NPI Last Update Date: | 04/07/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 27OA00529800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |