Wayne Optometric Associates LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OM00061200 Issued in NJ

Legal business name

WAYNE OPTOMETRIC ASSOCIATES LLC

Practice address

1595-2 RT. 23 So.
Wayne, NJ 07470-7508

Phone

(973) 633-1234

Fax

(973) 633-1307

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Fred J Siwiec

Title

Pres.

Phone

(973) 633-1234

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1255887964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595-2 ROUTE 23 SOUTH",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707508",
            "telephone_number": "973-633-1234",
            "fax_number": "973-633-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595-2 RT. 23 SO.",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707508",
            "telephone_number": "973-633-1234",
            "fax_number": "973-633-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE OPTOMETRIC ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "SIWIEC",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "973-633-1234",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00061200",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NJ",
            "license": "27OM00061200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.