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General NPI Number Information
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NPI Number | 1326262338
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Entity Type | Organization
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Legal Business Name | MAIN EYE GLASS CENTER, INC.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 1 N WASHINGTON AVE
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City | BERGENFIELD
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State | NJ
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Zip | 07621-2125
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Country | US
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Telephone | 201-384-7333
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Fax | 201-384-9915
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Provider Business Mailing Address
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Address Line | 1 N WASHINGTON AVE
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City | BERGENFIELD
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State | NJ
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Zip | 07621-2125
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Country | US
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Telephone | 201-384-7333
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Fax | 201-384-9915
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Authorized Official
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Title or Position | OWNER
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Name | JAMES ERIC DELLO RUSSO
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Credential | OD
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Telephone | 201-934-1221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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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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