Healthcare Provider Details
I. General information
NPI: 1942700745
Provider Name (Legal Business Name): ENHANCED EYECARE NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/19/2018
Last Update Date: 10/12/2024
Certification Date: 10/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 MALL DRIVE E LENSCRAFTERS MACYS
JERSEY CITY NJ
07310-1602
US
IV. Provider business mailing address
20 MALL DRIVE E LENSCRAFTERS MACYS
JERSEY CITY NJ
07310-1602
US
V. Phone/Fax
- Phone: 201-434-7800
- Fax: 201-216-0686
- Phone: 201-216-0672
- Fax: 201-216-0686
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 27OA00677900 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
BALVINDER
BHARJ
Title or Position: OPTOMETRIST
Credential: OD
Phone: 609-273-1807