Provider Demographics
NPI:1194756312
Name:AKT EYE CARE, LLC
Entity type:Organization
Organization Name:AKT EYE CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:GEE YOUNG
Authorized Official - Last Name:JOO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-944-9889
Mailing Address - Street 1:215 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5701
Mailing Address - Country:US
Mailing Address - Phone:201-944-9889
Mailing Address - Fax:201-944-9989
Practice Address - Street 1:215 MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5701
Practice Address - Country:US
Practice Address - Phone:201-944-9889
Practice Address - Fax:201-944-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00581500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ204644OtherCOLE MANAGED VISION
NJP3545665OtherOXFORD
NJ2944687OtherAETNA TRADITIONAL
NJ311462OtherNVA
NJ0053520Medicaid
NJ6397147OtherCIGNA
NJ3460860OtherAETNA HMO
NJ064964SREMedicare ID - Type UnspecifiedINDIVIDUAL PROVIDER NUMBE
NJ311462OtherNVA
NJ3460860OtherAETNA HMO
NJU92955Medicare UPIN