Provider Demographics
NPI:1639633803
Name:INTEGRATIVE VISION CORP
Entity Type:Organization
Organization Name:INTEGRATIVE VISION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIOIA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:732-389-2792
Mailing Address - Street 1:180 AVENUE AT THE CMN STE 6
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4569
Mailing Address - Country:US
Mailing Address - Phone:732-389-2792
Mailing Address - Fax:732-455-9583
Practice Address - Street 1:180 AVENUE AT THE CMN STE 6
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4569
Practice Address - Country:US
Practice Address - Phone:732-389-2792
Practice Address - Fax:732-455-9583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty