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General NPI Number Information
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NPI Number | 1366111486
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Entity Type | Organization
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Legal Business Name | O EYECARE NORTHVALE PC
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Dates
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Enumeration Date | 09/11/2021
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 271 LIVINGSTON ST STE S
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City | NORTHVALE
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State | NJ
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Zip | 07647-1916
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Country | US
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Telephone | 201-240-6397
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 HUDSON ST APT 1002
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City | FORT LEE
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State | NJ
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Zip | 07024-7222
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Country | US
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Telephone | 201-925-8774
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | HYUNJIN OH
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Credential |
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Telephone | 201-925-8774
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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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