Provider Demographics
NPI:1760846026
Name:ANGRIST OPTICAL LLC
Entity type:Organization
Organization Name:ANGRIST OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:ANGRIST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-892-5603
Mailing Address - Street 1:3810 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2054
Mailing Address - Country:US
Mailing Address - Phone:732-892-5603
Mailing Address - Fax:732-892-4309
Practice Address - Street 1:3810 RIVER RD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-2054
Practice Address - Country:US
Practice Address - Phone:732-892-5603
Practice Address - Fax:732-892-4309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04389500332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier