Provider Demographics
NPI:1427223759
Name:CENTRAL OPTIX INC
Entity Type:Organization
Organization Name:CENTRAL OPTIX INC
Other - Org Name:EYE CONTACT VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:R
Authorized Official - Last Name:FERREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:201-659-2774
Mailing Address - Street 1:368 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2828
Mailing Address - Country:US
Mailing Address - Phone:201-659-2774
Mailing Address - Fax:201-653-7319
Practice Address - Street 1:368 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2828
Practice Address - Country:US
Practice Address - Phone:201-659-2774
Practice Address - Fax:201-653-7319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00327300156FX1800X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0030155Medicaid
NJ0030155Medicaid