K&G Optical

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

TD3443 Issued in NJ

Legal business name

K&G OPTICAL

Practice address

1422 W Prospect St
East Brunswick, NJ 08816-1911

Phone

(732) 257-3755

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Vesta Kim, OPTITION

Title

Owner

Phone

(732) 257-3755

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346441987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 W PROSPECT ST",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161911",
            "telephone_number": "732-257-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 W PROSPECT ST",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161911",
            "telephone_number": "732-257-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K&G OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "VESTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-257-3755",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OPTITION"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NJ",
            "license": "TD3443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Exclusive Provider Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.