Provider Demographics
NPI:1891936027
Name:GEFEN OPTICAL, LLC
Entity Type:Organization
Organization Name:GEFEN OPTICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLUMENKRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-363-7505
Mailing Address - Street 1:30 GEFEN DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-3596
Mailing Address - Country:US
Mailing Address - Phone:732-363-7505
Mailing Address - Fax:732-363-2750
Practice Address - Street 1:30 GEFEN DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3596
Practice Address - Country:US
Practice Address - Phone:732-363-7505
Practice Address - Fax:732-363-2750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00356800332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier