Provider Demographics
NPI:1093839557
Name:GRIZONT, GREGORY (OPTITION)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:
Last Name:GRIZONT
Suffix:
Gender:M
Credentials:OPTITION
Other - Prefix:MS
Other - First Name:POLINA
Other - Middle Name:
Other - Last Name:GRIZONT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OPTITION
Mailing Address - Street 1:400 RENAISSANCE BLVD. OPTICAL VIEW
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902
Mailing Address - Country:US
Mailing Address - Phone:732-297-2020
Mailing Address - Fax:732-297-4747
Practice Address - Street 1:400 RENAISSANCE BLVD
Practice Address - Street 2:OPTICAL VIEW
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-5100
Practice Address - Country:US
Practice Address - Phone:732-297-2020
Practice Address - Fax:732-297-4747
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician