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General NPI Number Information
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NPI Number | 1801073820
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Entity Type | Organization
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Legal Business Name | GERALD A. YORK OPTICIAN
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 21 S FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1420
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Country | US
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Telephone | 908-766-0939
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Fax |
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Provider Business Mailing Address
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Address Line | 21 S FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1420
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Country | US
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Telephone | 908-766-0939
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GERALD A. YORK
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Credential | NJ LIC. OPTICIAN
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Telephone | 908-766-0939
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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 | D860
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License Number State | NJ
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