Eyeglass City Corp

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

EYEGLASS CITY CORP

Practice address

41 Clementon Rd
Store 328
Berlin, NJ 08009-1300

Phone

(856) 768-9583

Fax

(856) 939-0602

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Paul G Digiovanni

Title

Owner

Phone

(856) 768-9583

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104969088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 CLEMENTON RD",
            "address_2": "STORE 328",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080091300",
            "telephone_number": "856-768-9583",
            "fax_number": "856-939-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 CLEMENTON RD",
            "address_2": "STORE 328",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080091300",
            "telephone_number": "856-768-9583",
            "fax_number": "856-939-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEGLASS CITY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIGIOVANNI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-768-9583",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069973",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.