Provider Demographics
NPI:1265674345
Name:SPECS UNLIMITED INC.
Entity Type:Organization
Organization Name:SPECS UNLIMITED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-339-1266
Mailing Address - Street 1:521 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3735
Mailing Address - Country:US
Mailing Address - Phone:201-339-1266
Mailing Address - Fax:201-339-0122
Practice Address - Street 1:521 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3735
Practice Address - Country:US
Practice Address - Phone:201-339-1266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2061201Medicaid
NJ2061201Medicaid
NJ519840Medicare UPIN