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General NPI Number Information
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NPI Number | 1255650743
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Entity Type | Organization
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Legal Business Name | J& J PREMIUM EYE CARE INC
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Dates
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Enumeration Date | 05/23/2010
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 1304 GRAND AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1418
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Country | US
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Telephone | 516-442-1570
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Fax | 516-442-1573
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Provider Business Mailing Address
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Address Line | 1304 GRAND AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1418
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Country | US
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Telephone | 516-442-1570
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Fax | 516-442-1573
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES S ORR
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Credential | OPTICIAN
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Telephone | 516-442-1570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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