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General NPI Number Information
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NPI Number | 1730480849
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Entity Type | Organization
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Legal Business Name | ORANGE EYE CARE LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 225 MAIN ST
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City | ORANGE
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State | NJ
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Zip | 07050-3719
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Country | US
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Telephone | 973-678-2600
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Fax | 973-678-2621
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Provider Business Mailing Address
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Address Line | 225 MAIN ST
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City | ORANGE
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State | NJ
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Zip | 07050-3719
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Country | US
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Telephone | 973-678-2600
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Fax | 973-678-2621
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MILI CHITALIA
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Credential | O.D.
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Telephone | 973-678-2600
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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 | 27OA00601301
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License Number State | NJ
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