Provider Demographics
NPI:1861802746
Name:SERENITY VISION, LLC.
Entity type:Organization
Organization Name:SERENITY VISION, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAURIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-668-8320
Mailing Address - Street 1:9 COLONY DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2120
Mailing Address - Country:US
Mailing Address - Phone:732-668-8320
Mailing Address - Fax:
Practice Address - Street 1:1201 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3330
Practice Address - Country:US
Practice Address - Phone:732-244-1646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00634500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty