Provider Demographics
NPI:1013195049
Name:SPECIAL EYES
Entity Type:Organization
Organization Name:SPECIAL EYES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRITZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-335-5355
Mailing Address - Street 1:150 RIVER RD
Mailing Address - Street 2:BLDG C, SUITE 2
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9441
Mailing Address - Country:US
Mailing Address - Phone:973-335-5355
Mailing Address - Fax:973-335-5455
Practice Address - Street 1:150 RIVER RD
Practice Address - Street 2:BLDG C, SUITE 2
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9441
Practice Address - Country:US
Practice Address - Phone:973-335-5355
Practice Address - Fax:973-335-5455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00104502332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ638370001Medicaid
NJ638370001Medicaid