Provider Demographics
NPI:1326161308
Name:NOBEL EYEGLASSES
Entity Type:Organization
Organization Name:NOBEL EYEGLASSES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN---------MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED OPTICIAN
Authorized Official - Phone:201-433-5080
Mailing Address - Street 1:701 STATE RT 440
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1069
Mailing Address - Country:US
Mailing Address - Phone:201-433-5080
Mailing Address - Fax:201-435-1101
Practice Address - Street 1:701 STATE RT 440
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1069
Practice Address - Country:US
Practice Address - Phone:201-433-5080
Practice Address - Fax:201-435-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00083700156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty