| |
286 Market St, Elmwood Park, NJ 07407-2014 | |
(201) 797-5835 | |
(201) 797-2066 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 286 Market St, Elmwood Park, New Jersey |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922167717 | NPI | - | NPPES |
135706 | Medicaid | NJ | |
313195 | Other | NJ | NVA ID |
144225 | Other | NJ | EYEMED ID # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 27OA00518300 (New Jersey) | Primary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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286 Market St, Elmwood Park, NJ 07407-2014 Ph: (201) 797-5835 | 286 Market St, Elmwood Park, NJ 07407-2014 Ph: (201) 797-5835 |