Provider Demographics
NPI:1659869675
Name:UNION CITY VISION CARE PC
Entity Type:Organization
Organization Name:UNION CITY VISION CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI-LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-916-9224
Mailing Address - Street 1:3907 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-4819
Mailing Address - Country:US
Mailing Address - Phone:201-866-2020
Mailing Address - Fax:201-865-0123
Practice Address - Street 1:3907 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-4819
Practice Address - Country:US
Practice Address - Phone:201-866-2020
Practice Address - Fax:201-865-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00614201152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0287148Medicaid