MEDICARE: GLARING EYE HOLDINGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1568317923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLARING EYE HOLDINGS LLC

Provider Business Mailing Address
First Line	:	596 MCCHESNEY ST
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-1220
Country	:	US
Telephone Number	:	718-210-7085
Fax Number	:

Provider Business Practice Location Address
First Line	:	596 MCCHESNEY ST
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-1220
Country	:	US
Telephone Number	:	718-210-7085
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RONNIE WORTHEN JR.
Credential	:
Telephone Number	:	718-210-7085

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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