Provider Demographics
NPI:1366605289
Name:CITILIGHT OPTOMETRY, P.C.
Entity type:Organization
Organization Name:CITILIGHT OPTOMETRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-798-0303
Mailing Address - Street 1:30 MALL DR W STE 267
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-1603
Mailing Address - Country:US
Mailing Address - Phone:201-798-0303
Mailing Address - Fax:201-798-6021
Practice Address - Street 1:30 MALL DR W STE 267
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-1603
Practice Address - Country:US
Practice Address - Phone:201-798-0303
Practice Address - Fax:201-798-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00613000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty