Provider Demographics
NPI:1033263967
Name:SHORE OPTICAL
Entity Type:Organization
Organization Name:SHORE OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:STRIFFOLINO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:732-505-6400
Mailing Address - Street 1:530 LAKEHURST RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8063
Mailing Address - Country:US
Mailing Address - Phone:732-505-6400
Mailing Address - Fax:732-341-2794
Practice Address - Street 1:530 LAKEHURST RD
Practice Address - Street 2:SUITE 206
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8063
Practice Address - Country:US
Practice Address - Phone:732-505-6400
Practice Address - Fax:732-341-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00178900156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty