Healthcare Provider Details

I. General information

NPI: 1003003179
Provider Name (Legal Business Name): B & K OPTICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3391 STATE ROUTE 27
FRANKLIN PARK NJ
08823-1358
US

IV. Provider business mailing address

3391 STATE ROUTE 27
FRANKLIN PARK NJ
08823-1358
US

V. Phone/Fax

Practice location:
  • Phone: 732-940-0900
  • Fax:
Mailing address:
  • Phone: 732-940-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number31TD00189301
License Number StateNJ

VIII. Authorized Official

Name: JONATHAN BLEICH
Title or Position: PRESIDENT
Credential:
Phone: 732-940-0900