Healthcare Provider Details

I. General information

NPI: 1568432029
Provider Name (Legal Business Name): CATARACT AND EYE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17-15 MAPLE AVE 1ST FLOOR
FAIR LAWN NJ
07410-1552
US

IV. Provider business mailing address

17-15 MAPLE AVE 1ST FLOOR
FAIR LAWN NJ
07410-1552
US

V. Phone/Fax

Practice location:
  • Phone: 201-398-0077
  • Fax: 201-398-0042
Mailing address:
  • Phone: 201-398-0077
  • Fax: 201-398-0042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMA20486
License Number StateNJ

VIII. Authorized Official

Name: DR. NICHOLAS C TROTTA
Title or Position: SOLE PROPRIETER
Credential: M.D.
Phone: 201-262-3811