NPIMap

Organization Active NPI

Ridgedale Family Eye Care PC

  • Optometrist
  • Florham Park, NJ
National Provider Identifier
1003260134
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00590400 Issued in NJ
Legal business name
RIDGEDALE FAMILY EYE CARE PC
Practice address
171 Ridgedlale Ave.
Suite H
Florham Park, NJ 07932-1764
Phone
(973) 301-0400
NPI assigned
Apr 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jerrold Fruchtman, OD
Title
Owner
Phone
(973) 301-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 27OA00590400 NJ Primary

Addresses

Primary practice location

171 Ridgedlale Ave.
Suite H
Florham Park, NJ 07932-1764

Mailing address

171 Ridgedlale Ave.
Suite H
Florham Park, NJ 07932-1764
Phone (973) 301-0400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1003260134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 RIDGEDLALE AVE.",
            "address_2": "SUITE H",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321764",
            "telephone_number": "973-301-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 RIDGEDLALE AVE.",
            "address_2": "SUITE H",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321764",
            "telephone_number": "973-301-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEDALE FAMILY EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "FRUCHTMAN",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-301-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00590400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florham Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.