Provider Demographics
NPI:1912114190
Name:I G OPTICAL CORP.
Entity Type:Organization
Organization Name:I G OPTICAL CORP.
Other - Org Name:COHEN'S FASHION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TSINADZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-587-0122
Mailing Address - Street 1:1 GARDEN STATE PLAZA MALL
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-587-0122
Mailing Address - Fax:
Practice Address - Street 1:1 GARDEN STATE PLAZA MALL
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-587-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00320600156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty