Provider Demographics
NPI:1508520842
Name:I-CARE OPTOMETRY OF NJ PC
Entity Type:Organization
Organization Name:I-CARE OPTOMETRY OF NJ PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-635-7089
Mailing Address - Street 1:20980 CIPRES WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-1604
Mailing Address - Country:US
Mailing Address - Phone:267-635-7089
Mailing Address - Fax:315-612-9793
Practice Address - Street 1:64 NOTTINGHAM CT
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-2106
Practice Address - Country:US
Practice Address - Phone:267-635-7089
Practice Address - Fax:315-612-9793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty