Healthcare Provider Details

I. General information

NPI: 1609421148
Provider Name (Legal Business Name): HILLSDALE VISION CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 08/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 BROADWAY SUITE #1
HILLSDALE NJ
07642
US

IV. Provider business mailing address

185 BROADWAY SUITE #1
HILLSDALE NJ
07642
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-0230
  • Fax: 201-722-1111
Mailing address:
  • Phone: 201-666-0230
  • Fax: 201-722-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ADAM H. GARDNER
Title or Position: PRESIDENT
Credential: OD
Phone: 201-666-0230