Provider Demographics
NPI:1063637775
Name:G & A OPTICAL, INC.
Entity Type:Organization
Organization Name:G & A OPTICAL, INC.
Other - Org Name:LENS LAB EXPRESS OF PARAMUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-261-8020
Mailing Address - Street 1:193 ROUTE 17 SOUTH
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-261-8020
Mailing Address - Fax:201-261-8023
Practice Address - Street 1:193 ROUTE 17 SOUTH
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-261-8020
Practice Address - Fax:201-261-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00575100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID#