Healthcare Provider Details

I. General information

NPI: 1336087121
Provider Name (Legal Business Name): BRENDA MARQUEZ GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 88TH ST
NORTH BERGEN NJ
07047-4709
US

IV. Provider business mailing address

323 HIGHLAND AVE
PASSAIC NJ
07055-8609
US

V. Phone/Fax

Practice location:
  • Phone: 201-758-2895
  • Fax: 201-758-2897
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberTD4157
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: