Provider Demographics
NPI:1366111486
Name:O EYECARE NORTHVALE PC
Entity type:Organization
Organization Name:O EYECARE NORTHVALE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:HYUNJIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-925-8774
Mailing Address - Street 1:2030 HUDSON ST APT 1002
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7222
Mailing Address - Country:US
Mailing Address - Phone:201-925-8774
Mailing Address - Fax:
Practice Address - Street 1:271 LIVINGSTON ST STE S
Practice Address - Street 2:
Practice Address - City:NORTHVALE
Practice Address - State:NJ
Practice Address - Zip Code:07647-1916
Practice Address - Country:US
Practice Address - Phone:201-240-6397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-11
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty