Provider Demographics
NPI:1922091255
Name:DR SUZANNE OFFEN INC
Entity Type:Organization
Organization Name:DR SUZANNE OFFEN INC
Other - Org Name:OFFEN EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:OFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-789-1177
Mailing Address - Street 1:524 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3312
Mailing Address - Country:US
Mailing Address - Phone:908-789-1177
Mailing Address - Fax:908-789-7431
Practice Address - Street 1:518 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3312
Practice Address - Country:US
Practice Address - Phone:908-789-1177
Practice Address - Fax:908-789-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00437900152W00000X
NJ27TO00014400152W00000X
NJ27OA00437900152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3319008Medicaid
6638968OtherCIGNA PPO
000034945OtherHORIZON BC
410026253OtherRAILROAD MEDICARE
000034945OtherHORIZON BC
6638968OtherCIGNA PPO