Provider Demographics
NPI:1245365774
Name:DAWN OPTICIANS, LLC
Entity type:Organization
Organization Name:DAWN OPTICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MORANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-762-9100
Mailing Address - Street 1:63 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1855
Mailing Address - Country:US
Mailing Address - Phone:973-762-9100
Mailing Address - Fax:
Practice Address - Street 1:63 2ND ST
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1855
Practice Address - Country:US
Practice Address - Phone:973-762-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00162700332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5975060001Medicare NSC