Provider Demographics
NPI:1922375203
Name:NIJAL EYECARE INC
Entity Type:Organization
Organization Name:NIJAL EYECARE INC
Other - Org Name:EDGEWATER EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NILESH
Authorized Official - Middle Name:N
Authorized Official - Last Name:PAPAIYA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-340-6406
Mailing Address - Street 1:1420 12TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-2004
Mailing Address - Country:US
Mailing Address - Phone:201-340-6406
Mailing Address - Fax:201-340-6407
Practice Address - Street 1:75 RIVER RD
Practice Address - Street 2:SUITE 210
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1073
Practice Address - Country:US
Practice Address - Phone:201-340-6406
Practice Address - Fax:201-340-6407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJOA006006152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1649337809OtherNPI
NJ1649337809OtherNPI