Provider Demographics
NPI:1598509879
Name:JG OPTICAL INC.
Entity type:Organization
Organization Name:JG OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-743-1331
Mailing Address - Street 1:825 BLOOMFIELD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1300
Mailing Address - Country:US
Mailing Address - Phone:973-746-0422
Mailing Address - Fax:862-277-4918
Practice Address - Street 1:825 BLOOMFIELD AVE STE 101
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1300
Practice Address - Country:US
Practice Address - Phone:973-746-5665
Practice Address - Fax:862-277-4918
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JG OPTICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-21
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty