Mickey, Kevin J

Mickey, Kevin J is an individual health care provider with primary practice located at 57 Willowbrook Blvd Suite 411, Wayne NJ 07470-7045. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mickey, Kevin J can be contacted via phone (973) 256-4111.

Contact Information

Primary practice address
57 Willowbrook Blvd Suite 411 Wayne NJ 07470-7045
Phone: (973) 256-4111
Fax: (973) 256-3719
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 25MA05006300 New Jersey

Profile Details

NPI number 1538101662
LBN Legal business name Mickey, Kevin J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Apr 20th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538101662 NPPES
New Jersey MEDICAID 1141708
New Jersey Other 25MA05006300

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