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General NPI Number Information
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NPI Number | 1730217365
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Entity Type | Organization
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Legal Business Name | ANGRIST OPTICAL LLC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 1527 STATE ROUTE 27 STE 2600
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City | SOMERSET
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State | NJ
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Zip | 08873-3979
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Country | US
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Telephone | 732-246-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 1527 STATE ROUTE 27 STE 2600
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City | SOMERSET
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State | NJ
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Zip | 08873-3979
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Country | US
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Telephone | 732-246-1050
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD C ANGRIST
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Credential | MD
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Telephone | 732-246-1050
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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 | 25MA04389500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 25MA04389500
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License Number State | NJ
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