Provider Demographics
NPI:1104297795
Name:TTL VISON ASSOCIATES INC
Entity type:Organization
Organization Name:TTL VISON ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:OKANE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-432-6750
Mailing Address - Street 1:195 1/2 NEWARK AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-2813
Mailing Address - Country:US
Mailing Address - Phone:201-432-6750
Mailing Address - Fax:201-432-2931
Practice Address - Street 1:195 1/2 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-2813
Practice Address - Country:US
Practice Address - Phone:201-432-6750
Practice Address - Fax:201-432-2931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherHORIZON
NJ=========OtherHORIZON