Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric Ophthalmology of Nj, PC

Organization Ophthalmology Physician · NPI 1164460218

Pediatric Ophthalmology of Nj, PC is an Ophthalmology Physician in Wayne, New Jersey. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

57 Willowbrook Blvd Ste 411
Wayne, NJ 07470-7047
Phone: (973) 256-4111
Fax: (973) 256-3719
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X
Pediatric Ophthalmology and Strabismus Specialist Physician Taxonomy 207WX0110X

Record details

NPI number1164460218
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Mickey — President · (973) 256-4111
NPI enumeratedJune 2, 2006
Last updated in NPPESApril 20, 2020
Certification dateApril 20, 2020
Mailing address57 Willowbrook Blvd, Suite 411, Wayne, NJ 07470-7047

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