Healthcare Provider Details

I. General information

NPI: 1104046911
Provider Name (Legal Business Name): OPTICAL OPTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 STATE ROUTE 10
RANDOLPH NJ
07869-2142
US

IV. Provider business mailing address

477 STATE ROUTE 10 SUITE 103
RANDOLPH NJ
07869-2142
US

V. Phone/Fax

Practice location:
  • Phone: 973-328-1508
  • Fax:
Mailing address:
  • Phone: 973-328-1508
  • Fax: 973-328-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: SHARON B WALKER
Title or Position: VICE PRESIDENT
Credential:
Phone: 973-328-1508