Provider Demographics
NPI:1063059277
Name:OPTICAL WORLD OF GLOUCESTER COUNTY, PA
Entity type:Organization
Organization Name:OPTICAL WORLD OF GLOUCESTER COUNTY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-848-6400
Mailing Address - Street 1:1750 DEPTFORD CENTER RD
Mailing Address - Street 2:DEPTFORD MALL SUITE 1124
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096
Mailing Address - Country:US
Mailing Address - Phone:856-848-6400
Mailing Address - Fax:
Practice Address - Street 1:1750 DEPTFORD CENTER RD
Practice Address - Street 2:DEPTFORD MALL SUITE 1124
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096
Practice Address - Country:US
Practice Address - Phone:856-848-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty