Healthcare Provider Details

I. General information

NPI: 1669524583
Provider Name (Legal Business Name): C & J OPTICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 WALNUT ST STE 1
PHILADELPHIA PA
19103-6148
US

IV. Provider business mailing address

1704 WALNUT ST STE 1
PHILADELPHIA PA
19103-6148
US

V. Phone/Fax

Practice location:
  • Phone: 215-732-7622
  • Fax: 215-732-7626
Mailing address:
  • Phone: 215-732-7622
  • Fax: 215-732-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH A VIRONE
Title or Position: OWNER
Credential:
Phone: 215-732-7622