Provider Demographics
NPI:1417054800
Name:ARCOMANO, JON PATRICK (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:PATRICK
Last Name:ARCOMANO
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5364
Mailing Address - Country:US
Mailing Address - Phone:732-870-0070
Mailing Address - Fax:732-870-3350
Practice Address - Street 1:604 2ND AVENUE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-5364
Practice Address - Country:US
Practice Address - Phone:732-870-0070
Practice Address - Fax:732-870-3350
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ D 1241156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician