Provider Demographics
NPI:1639350424
Name:MARK ZALESKI T/A ALBERT MINELLI OPTICIANS
Entity Type:Organization
Organization Name:MARK ZALESKI T/A ALBERT MINELLI OPTICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ZALESKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-729-3839
Mailing Address - Street 1:55 SPARTA AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1815
Mailing Address - Country:US
Mailing Address - Phone:973-729-3839
Mailing Address - Fax:973-726-0651
Practice Address - Street 1:55 SPARTA AVE
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1815
Practice Address - Country:US
Practice Address - Phone:973-729-3839
Practice Address - Fax:973-726-0651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty