Individual provider Active NPI

Andrew Michael Reznik

  • Optician
  • Toms River, NJ
National Provider Identifier
1174215636
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
31TD00353300 Issued in NJ
Practice address
950 Rte 37 W
Toms River, NJ 08755-5018
Phone
(732) 914-4721
Fax
(732) 914-4765
NPI assigned
May 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 31TD00353300 NJ Primary

Addresses

Primary practice location

950 Rte 37 W
Toms River, NJ 08755-5018

Mailing address

1002 Mississippi St
Toms River, NJ 08755-6389
Phone (908) 421-6894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31TD00353300NJMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1174215636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 MISSISSIPPI ST",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087556389",
            "telephone_number": "908-421-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 RTE 37 W",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087555018",
            "telephone_number": "732-914-4721",
            "fax_number": "732-914-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNIK",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": "31TD00353300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.