| NPI | 1154720126 |
|---|---|
| Doing Business As | PAVONIA OPTICAL |
| Entity Type | Organization |
| Authorized Contact | WILLIAM CONSTAD Member 973-912-9773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2015-01-05 |