Healthcare Provider Details

I. General information

NPI: 1427223759
Provider Name (Legal Business Name): CENTRAL OPTIX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 10/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

368 CENTRAL AVE
JERSEY CITY NJ
07307-2828
US

IV. Provider business mailing address

368 CENTRAL AVE
JERSEY CITY NJ
07307-2828
US

V. Phone/Fax

Practice location:
  • Phone: 201-659-2774
  • Fax: 201-653-7319
Mailing address:
  • Phone: 201-659-2774
  • Fax: 201-653-7319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number31TD00327300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number31TD00327300
License Number StateNJ

VIII. Authorized Official

Name: MR. SERGIO R FERREIRA
Title or Position: PRESIDENT
Credential: L.D.O.
Phone: 201-659-2774