Provider Demographics
NPI:1154838316
Name:NJ EYE AND EAR LLC
Entity Type:Organization
Organization Name:NJ EYE AND EAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KROL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-546-5700
Mailing Address - Street 1:1016 MAIN AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2327
Mailing Address - Country:US
Mailing Address - Phone:973-546-5700
Mailing Address - Fax:800-878-2811
Practice Address - Street 1:1016 MAIN AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2327
Practice Address - Country:US
Practice Address - Phone:973-546-5700
Practice Address - Fax:800-878-2811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NJ EYE AND EAR, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty