Provider Demographics
NPI:1316080252
Name:LENS LAB EXPRESS OF WEST NEW YORK,INC.
Entity type:Organization
Organization Name:LENS LAB EXPRESS OF WEST NEW YORK,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-861-0016
Mailing Address - Street 1:5917 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1306
Mailing Address - Country:US
Mailing Address - Phone:201-861-0016
Mailing Address - Fax:201-861-7303
Practice Address - Street 1:5917 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1306
Practice Address - Country:US
Practice Address - Phone:201-861-0016
Practice Address - Fax:201-861-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTD00213300156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty