Healthcare Provider Details

I. General information

NPI: 1871967356
Provider Name (Legal Business Name): BALVINDER BHARJ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MALL DRIVE EAST LENSCRAFTERS MACYS
JERSEY CITY NJ
07310
US

IV. Provider business mailing address

20 MALL DRIVE EAST LENSCRAFTERS MACYS
JERSEY CITY NJ
07310
US

V. Phone/Fax

Practice location:
  • Phone: 201-216-0672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV008380
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00677900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: