Provider Demographics
NPI:1508053760
Name:PAUL NAFTALI O D P A
Entity Type:Organization
Organization Name:PAUL NAFTALI O D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAFTALI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-377-1060
Mailing Address - Street 1:311 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-2338
Mailing Address - Country:US
Mailing Address - Phone:973-377-1060
Mailing Address - Fax:973-660-1133
Practice Address - Street 1:311 MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2338
Practice Address - Country:US
Practice Address - Phone:973-377-1060
Practice Address - Fax:973-660-1133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00510800152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
644815Medicare PIN
NJ1009840001Medicare NSC