| NPI | 1376831776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PARAG CHAMPAKLAL RAITHATHA Ophthalmic Dispenser 973-357-8357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician (Licence: NJ TD-3405) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2012-08-21 |