Provider Demographics
NPI:1073308318
Name:UPPER MONTCLAIR EYE CARE & WEAR LLC
Entity type:Organization
Organization Name:UPPER MONTCLAIR EYE CARE & WEAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSTAGI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-450-5264
Mailing Address - Street 1:211 BELLEVUE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1885
Mailing Address - Country:US
Mailing Address - Phone:201-450-5264
Mailing Address - Fax:
Practice Address - Street 1:211 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1885
Practice Address - Country:US
Practice Address - Phone:201-450-5264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty