Provider Demographics
NPI:1982317350
Name:BAYONNE VISION LLC
Entity Type:Organization
Organization Name:BAYONNE VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ANKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARIPELLA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-489-5648
Mailing Address - Street 1:42 SHAWNEE WAY
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2009
Mailing Address - Country:US
Mailing Address - Phone:908-489-5648
Mailing Address - Fax:
Practice Address - Street 1:590 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3826
Practice Address - Country:US
Practice Address - Phone:201-823-3998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1386184232OtherNPI 1