Provider Demographics
NPI:1558973933
Name:FAMILY FIRST VISION CARE NEW JERSEY LLC
Entity Type:Organization
Organization Name:FAMILY FIRST VISION CARE NEW JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-545-4465
Mailing Address - Street 1:556 N STATE RT 17
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3008
Mailing Address - Country:US
Mailing Address - Phone:201-670-0010
Mailing Address - Fax:
Practice Address - Street 1:556 N STATE RT 17
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3008
Practice Address - Country:US
Practice Address - Phone:201-670-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty