{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1003997909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CHESTNUT ST",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042275",
            "telephone_number": "908-245-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CHESTNUT ST",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042275",
            "telephone_number": "908-245-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION OPTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-245-0900"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2989107-01",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle Park, NJ

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.