Aviva C Graff Distenfeld, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00585100 Issued in NJ

Practice address

680 Broadway
Suite 114
Paterson, NJ 07514-1422

Phone

(973) 742-4747

Fax

(973) 742-0629

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Jersey Center for Sight, LLC

  • Low Vision Rehabilitation Optometrist
  • Paterson, NJ
  • NPI 1437256641
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1104977073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 BROADWAY",
            "address_2": "STE 114",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141526",
            "telephone_number": "973-742-4747",
            "fax_number": "973-742-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BROADWAY",
            "address_2": "SUITE 114",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141422",
            "telephone_number": "973-742-4747",
            "fax_number": "973-742-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAFF DISTENFELD",
        "first_name": "AVIVA",
        "middle_name": "C",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00585100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Ann Gottlieb
• Grace Alone ABA LLC
• Gracey'S Vision Healthcare Inc.
• Gracey'S Vision Healthcare Inc.
• Gracey'S Vision Healthcare Inc.
• Monique Graham
• Grand Street Pharmacy LLC
• Tamoy Grant
• Linda M Graves, M.D.
• Steven Gravier-Leon, MD

• Optometrist in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.