Provider Demographics
NPI:1932279981
Name:VALLEY VISION CARE, P.C.
Entity Type:Organization
Organization Name:VALLEY VISION CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FAVREAU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-827-4120
Mailing Address - Street 1:418 ROUTE 23
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416
Mailing Address - Country:US
Mailing Address - Phone:973-827-4120
Mailing Address - Fax:973-827-0782
Practice Address - Street 1:418 ROUTE 23
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416
Practice Address - Country:US
Practice Address - Phone:973-827-4120
Practice Address - Fax:973-827-0782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087408Medicare ID - Type Unspecified
NJU08578Medicare UPIN