Provider Demographics
NPI:1003361775
Name:VISION LOSS ALLIANCE OF NEW JERSEY
Entity Type:Organization
Organization Name:VISION LOSS ALLIANCE OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCHULDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-627-0055
Mailing Address - Street 1:VISION LOSS ALLIANCE OF NEW JERSEY
Mailing Address - Street 2:155 MORRIS AVE., SUITE 2
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-1736
Mailing Address - Country:US
Mailing Address - Phone:973-627-0055
Mailing Address - Fax:973-627-1622
Practice Address - Street 1:155 MORRIS AVE.
Practice Address - Street 2:SUITE 2
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-1736
Practice Address - Country:US
Practice Address - Phone:973-627-0055
Practice Address - Fax:973-627-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation