Provider Demographics
NPI:1639221930
Name:HIGHLAND PARK VISION CENTER P.A.
Entity Type:Organization
Organization Name:HIGHLAND PARK VISION CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-565-2020
Mailing Address - Street 1:PO BOX 4466
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-4466
Mailing Address - Country:US
Mailing Address - Phone:732-565-2020
Mailing Address - Fax:
Practice Address - Street 1:590 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3826
Practice Address - Country:US
Practice Address - Phone:201-523-3998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00473400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJOAO4734OtherSTATE LICENCE
NJOAO4734OtherSTATE LICENCE