Provider Demographics
NPI:1568432029
Name:CATARACT AND EYE CENTER PC
Entity Type:Organization
Organization Name:CATARACT AND EYE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:TROTTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-262-3811
Mailing Address - Street 1:17-15 MAPLE AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1552
Mailing Address - Country:US
Mailing Address - Phone:201-398-0077
Mailing Address - Fax:201-398-0042
Practice Address - Street 1:17-15 MAPLE AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1552
Practice Address - Country:US
Practice Address - Phone:201-398-0077
Practice Address - Fax:201-398-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA20486173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1499106Medicaid
NJ1499106Medicaid