Provider Demographics
NPI:1861661357
Name:NORTH JERSEY EYE CARE CENTER
Entity type:Organization
Organization Name:NORTH JERSEY EYE CARE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIEST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-697-8100
Mailing Address - Street 1:2713 STATE RT 23
Mailing Address - Street 2:P. O. BOX 733
Mailing Address - City:NEWFOUNDLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07435-1414
Mailing Address - Country:US
Mailing Address - Phone:973-697-8100
Mailing Address - Fax:973-697-8104
Practice Address - Street 1:2713 STATE RT 23
Practice Address - Street 2:
Practice Address - City:NEWFOUNDLAND
Practice Address - State:NJ
Practice Address - Zip Code:07435-1414
Practice Address - Country:US
Practice Address - Phone:973-697-8100
Practice Address - Fax:973-697-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM00028400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ575057Medicare PIN
NJ0302220001Medicare NSC
NJT88962Medicare UPIN