Provider Demographics
NPI:1194531400
Name:AURORA EYECARE OF ALASKA
Entity type:Organization
Organization Name:AURORA EYECARE OF ALASKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGHESE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-640-0161
Mailing Address - Street 1:25 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2050
Mailing Address - Country:US
Mailing Address - Phone:973-640-0161
Mailing Address - Fax:
Practice Address - Street 1:25 STANFORD AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2050
Practice Address - Country:US
Practice Address - Phone:973-640-0161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty