Provider Demographics
NPI:1033260062
Name:NATIONAL RESOURCE GROUP INC.
Entity Type:Organization
Organization Name:NATIONAL RESOURCE GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:
Authorized Official - First Name:FAHARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAWANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-348-2904
Mailing Address - Street 1:4 BOYARD CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1600
Mailing Address - Country:US
Mailing Address - Phone:732-348-2904
Mailing Address - Fax:
Practice Address - Street 1:COHEN'S FASHION OPTICAL
Practice Address - Street 2:301 MT HOPE AVE
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866
Practice Address - Country:US
Practice Address - Phone:973-366-2072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA005796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ081877Medicare ID - Type UnspecifiedID NUMBER