Provider Demographics
NPI:1528511524
Name:NJ OPTICAL INC
Entity type:Organization
Organization Name:NJ OPTICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QI CHAO
Authorized Official - Middle Name:
Authorized Official - Last Name:LUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-222-6400
Mailing Address - Street 1:243 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-3073
Mailing Address - Country:US
Mailing Address - Phone:201-222-5401
Mailing Address - Fax:
Practice Address - Street 1:355 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2923
Practice Address - Country:US
Practice Address - Phone:201-222-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OM0078900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty