| NPI | 1235155615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES DELLO RUSSO Medical Director 201-244-3177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NJ 27TO00121200) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA06768400) |
| 207W00000X Ophthalmology (Licence: NJ 25MA2132400) | |
| 207W00000X Ophthalmology (Licence: NJ 25MA07418400) | |
| 207W00000X Ophthalmology (Licence: NJ 25MA06472800) | |
| 207W00000X Ophthalmology (Licence: NJ 25MA06568400) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2021-01-15 |