Provider Demographics
NPI:1508909458
Name:W.E.V. JR. INC.
Entity Type:Organization
Organization Name:W.E.V. JR. INC.
Other - Org Name:PEARLE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VASSLIDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-825-6020
Mailing Address - Street 1:3849 S DELSEA DR
Mailing Address - Street 2:CUMBERLAND MALL
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7408
Mailing Address - Country:US
Mailing Address - Phone:856-825-6020
Mailing Address - Fax:856-825-1147
Practice Address - Street 1:3849 S DELSEA DR
Practice Address - Street 2:CUMBERLAND MALL
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7408
Practice Address - Country:US
Practice Address - Phone:856-825-6020
Practice Address - Fax:856-825-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD-1274156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0719150001Medicare ID - Type Unspecified