Provider Demographics
NPI:1588236079
Name:ARIZMENDY, ANGEL (OD)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:ARIZMENDY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:ANGEL
Other - Middle Name:
Other - Last Name:ARIZMENDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:26 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2267
Mailing Address - Country:US
Mailing Address - Phone:732-303-9555
Mailing Address - Fax:
Practice Address - Street 1:26 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2267
Practice Address - Country:US
Practice Address - Phone:732-303-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00705700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist