Provider Demographics
NPI:1346391372
Name:DEL MINELLI OPTICAL CENTER INC.
Entity Type:Organization
Organization Name:DEL MINELLI OPTICAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-383-3650
Mailing Address - Street 1:128 WATER ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-1415
Mailing Address - Country:US
Mailing Address - Phone:973-383-3650
Mailing Address - Fax:973-383-8465
Practice Address - Street 1:128 WATER ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-1415
Practice Address - Country:US
Practice Address - Phone:973-383-3650
Practice Address - Fax:973-383-8465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1663156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ117249OtherEYEMED
NJ760OtherVISION SCREENING
NJ313225OtherN.V.A.
NJ313225OtherN.V.A.