Provider Demographics
NPI:1366872392
Name:EYE EXAM PLUS
Entity type:Organization
Organization Name:EYE EXAM PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CZERNIAWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:551-580-3512
Mailing Address - Street 1:521 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1771
Mailing Address - Country:US
Mailing Address - Phone:551-580-3512
Mailing Address - Fax:
Practice Address - Street 1:40 INTERNATIONAL DR S
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-4106
Practice Address - Country:US
Practice Address - Phone:201-869-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty