Organization Active NPI

Advanced Eyecare of Washington, LLC

  • Optometrist
  • Washington, NJ
National Provider Identifier
1275972721
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA000514000 Issued in NJ
Legal business name
ADVANCED EYECARE OF WASHINGTON, LLC
Practice address
15 W Washington Ave
Washington, NJ 07882-1916
Phone
(908) 689-0240
Fax
(908) 689-0676
NPI assigned
Jun 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Dr. Gigette Collazo Harfst, O.D.
Title
Clinical Director / Ceo
Phone
(908) 689-0240

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 27OA000514000 NJ Primary

Addresses

Primary practice location

15 W Washington Ave
Washington, NJ 07882-1916

Mailing address

15 W Washington Ave
Washington, NJ 07882-1916
Phone (908) 689-0240

Other identifiers 1

IdentifierTypeStateIssuer
313860YT46OtherNJMEDICARE GROUP MEMBER PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

15 W Washington Ave
Washington, NJ 07882
Phone (908) 689-0240

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1275972721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W WASHINGTON AVE",
            "city": "WASHINGTON",
            "state": "NJ",
            "postal_code": "078821916",
            "telephone_number": "908-689-0240",
            "fax_number": "908-689-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W WASHINGTON AVE",
            "city": "WASHINGTON",
            "state": "NJ",
            "postal_code": "078821916",
            "telephone_number": "908-689-0240",
            "fax_number": "908-689-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYECARE OF WASHINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "HARFST",
        "authorized_official_first_name": "GIGETTE",
        "authorized_official_middle_name": "COLLAZO",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR / CEO",
        "authorized_official_telephone_number": "908-689-0240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA000514000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP MEMBER PROVIDER NUMBER",
            "identifier": "313860YT46",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.