Provider Demographics
NPI:1528247699
Name:FAILLA RADO, CINDY J (OD)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:J
Last Name:FAILLA RADO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BRICK MALL
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4163
Mailing Address - Country:US
Mailing Address - Phone:732-341-1600
Mailing Address - Fax:732-534-0095
Practice Address - Street 1:105 BRICK MALL
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4163
Practice Address - Country:US
Practice Address - Phone:732-341-1600
Practice Address - Fax:732-534-0095
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-25
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00536600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223518555OtherHORIZON BC BS OF NJ
NJ223518555OtherAETNA
NJ223518555OtherQUALCARE
NJ831631ZB3XMedicare PIN
NJ223518555OtherAETNA