Provider Demographics
NPI:1235678665
Name:MOBILE VISION GROUP LLC
Entity Type:Organization
Organization Name:MOBILE VISION GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-797-2747
Mailing Address - Street 1:4-14 SADDLE RIVER RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5632
Mailing Address - Country:US
Mailing Address - Phone:201-797-2747
Mailing Address - Fax:201-797-5809
Practice Address - Street 1:4-14 SADDLE RIVER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-5632
Practice Address - Country:US
Practice Address - Phone:201-797-2747
Practice Address - Fax:201-797-5809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5742152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty