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General NPI Number Information
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NPI Number | 1235867698
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Entity Type | Organization
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Legal Business Name | SPECTACULAR EYE CARE, LLC
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Dates
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Enumeration Date | 08/12/2022
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 2 SOUTH AVE W STE 5
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City | CRANFORD
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State | NJ
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Zip | 07016-2687
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Country | US
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Telephone | 908-287-5287
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Fax | 908-287-5285
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Provider Business Mailing Address
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Address Line | 2 SOUTH AVE W STE 5
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City | CRANFORD
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State | NJ
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Zip | 07016-2687
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Country | US
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Telephone | 908-287-5287
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Fax | 908-287-5285
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. KATARZYNA CIESEK
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Credential | OD
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Telephone | 908-278-4684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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