Provider Demographics
NPI:1558621441
Name:OPTICAL FASHION GROUP OF ENGLEWOOD INC
Entity Type:Organization
Organization Name:OPTICAL FASHION GROUP OF ENGLEWOOD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISFELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-894-1400
Mailing Address - Street 1:17 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3508
Mailing Address - Country:US
Mailing Address - Phone:201-894-1400
Mailing Address - Fax:201-894-0220
Practice Address - Street 1:17 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3508
Practice Address - Country:US
Practice Address - Phone:201-894-1400
Practice Address - Fax:201-894-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00389700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========0OtherHORIZON
NJ=========0OtherHORIZON