Provider Demographics
NPI:1184822678
Name:IN FOCUS VISION
Entity type:Organization
Organization Name:IN FOCUS VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:SELBRENA
Authorized Official - Last Name:CORBIN-SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-981-8000
Mailing Address - Street 1:1100 CENTENNIAL AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4152
Mailing Address - Country:US
Mailing Address - Phone:732-981-8000
Mailing Address - Fax:732-981-8070
Practice Address - Street 1:1100 CENTENNIAL AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4152
Practice Address - Country:US
Practice Address - Phone:732-981-8000
Practice Address - Fax:732-981-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
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
NJ084675Medicare ID - Type Unspecified