Custom Eyes LLC

Primary specialty

OpticianTaxonomy code 156FX1800X

License

31TD00135400 Issued in NJ

Legal business name

CUSTOM EYES LLC

Practice address

162 Summerhill Rd
East Brunswick, NJ 08816-4929

Phone

(732) 613-3937

Fax

(732) 613-3969

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Wayne L Gonchar

Title

President

Phone

(732) 613-3937

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1124185582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 SUMMERHILL RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164929",
            "telephone_number": "732-613-3937",
            "fax_number": "732-613-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 SUMMERHILL RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164929",
            "telephone_number": "732-613-3937",
            "fax_number": "732-613-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM EYES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "GONCHAR",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-613-3937",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": "31TD00135400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Optometric Eyecare, P.C.
• Crystal Smiles, LLC
• Marcella Cudjoe, APN
• Shanique Curry
• Cole John Cusanelli, PT, DPT
• Customize Me, LLC.
• Cybermed Corporation
• Nicole B Czarnecki, RDN
• Michael A D'Addona, MA, LPC, CCMHC, NCC
• Francis C D'Mello, M.D.

• Optician in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Optician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.