Provider Demographics
NPI:1225191828
Name:DANZ INC
Entity Type:Organization
Organization Name:DANZ INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:DANZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCO
Authorized Official - Phone:973-783-2955
Mailing Address - Street 1:460 BLOOMFIELD AVE
Mailing Address - Street 2:ROOM 302
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3582
Mailing Address - Country:US
Mailing Address - Phone:973-783-2955
Mailing Address - Fax:201-444-4007
Practice Address - Street 1:460 BLOOMFIELD AVE
Practice Address - Street 2:ROOM 302
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3582
Practice Address - Country:US
Practice Address - Phone:973-783-2955
Practice Address - Fax:201-444-4007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04334841Medicaid
NJ0132820001Medicare ID - Type Unspecified
NJ42591OtherAMERI GROUP
NYG66801OtherBLUE SHIELD WELL CHOICE