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General NPI Number Information
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NPI Number | 1487957684
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Entity Type | Organization
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Legal Business Name | LOUIS EYECARE LLC
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Dates
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Enumeration Date | 12/09/2010
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 3513 JF KENNEDY BLVD
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City | JERSEY CITY
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State | NJ
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Zip | 07307-0000
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Country | US
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Telephone | 201-420-8162
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Fax |
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Provider Business Mailing Address
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Address Line | 3513 JF KENNEDY BLVD
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City | JERSEY CITY
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State | NJ
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Zip | 07307
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Country | US
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Telephone | 201-420-8162
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JOHN C SCARAMIA
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Credential | OD
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Telephone | 201-420-8162
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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 | 27OA00506400
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License Number State | NJ
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