MEDICARE: MR. BESMIR ZGJANI

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	156FX1800X	Optician	31TD00393800	NJ

General Provider Information

NPI Number	:	1598293672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BESMIR ZGJANI

Provider Business Mailing Address
First Line	:	68 SKYLINE LAKE DR
Second Line	:
City	:	RINGWOOD
State	:	NJ
Zip	:	07456-1917
Country	:	US
Telephone Number	:	973-668-3579
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 MOUNT HOPE AVE STE 2005
Second Line	:
City	:	ROCKAWAY
State	:	NJ
Zip	:	07866-2128
Country	:	US
Telephone Number	:	973-668-3579
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2017
Last Update Date	:	06/01/2017

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