Provider Demographics
NPI:1568668416
Name:JOSEPH DURAN PROFESSIONAL ASSCOCIATION INC.
Entity Type:Organization
Organization Name:JOSEPH DURAN PROFESSIONAL ASSCOCIATION INC.
Other - Org Name:OPTIVISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:OPHTHALMIC DISPENSER
Authorized Official - Phone:201-861-1234
Mailing Address - Street 1:6110 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1568
Mailing Address - Country:US
Mailing Address - Phone:201-861-1234
Mailing Address - Fax:
Practice Address - Street 1:6110 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1568
Practice Address - Country:US
Practice Address - Phone:201-861-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty