| Optical Outlet Llc | |
|
977 Main St, Paterson, NJ 07503-2329 | |
| (973) 684-8400 | |
| (973) 684-8401 |
| Full Name | Optical Outlet Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 977 Main St, Paterson, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851550016 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Vittorio Mena |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1942698717 PECOS PAC ID: 9830468701 Enrollment ID: I20180403000406 |
| Mailing Address | Practice Location Address |
|---|---|
| Optical Outlet Llc 977 Main St, Paterson, NJ 07503-2329 Ph: (973) 684-8400 | Optical Outlet Llc 977 Main St, Paterson, NJ 07503-2329 Ph: (973) 684-8400 |
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