MEDICARE: UNION CITY VISION CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	27OA00614201	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659869675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION CITY VISION CARE PC

Provider Business Mailing Address
First Line	:	3907 BERGENLINE AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-4819
Country	:	US
Telephone Number	:	201-866-2020
Fax Number	:	201-865-0123

Provider Business Practice Location Address
First Line	:	3907 BERGENLINE AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-4819
Country	:	US
Telephone Number	:	201-866-2020
Fax Number	:	201-865-0123

Authorized Official
Title or Position	:	OD
Name	:	DR. JESSICA CHOI-LEE
Credential	:	OD
Telephone Number	:	201-916-9224

Provider Enumeration Date	:	04/25/2018
Last Update Date	:	04/25/2018

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Directions to “UNION CITY VISION CARE PC ” Practice Location

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