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General NPI Number Information
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NPI Number | 1770867434
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Entity Type | Organization
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Legal Business Name | EXCHANGE PLACE EYE ASSOCIATES
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 66 YORK ST
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City | JERSEY CITY
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State | NJ
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Zip | 07302-3838
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Country | US
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Telephone | 201-855-9789
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Fax |
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Provider Business Mailing Address
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Address Line | 66 YORK ST
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City | JERSEY CITY
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State | NJ
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Zip | 07302-3838
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Country | US
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Telephone | 201-855-9789
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON CHEN
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Credential | OD
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Telephone | 201-855-9789
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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 | 27OA00624500
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License Number State | NJ
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