NPIMap

Organization Active NPI

Tko Optical Inc.

  • Eyewear Supplier
  • East Orange, NJ
National Provider Identifier
1356512511
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
31TD180700 Issued in NJ
Legal business name
TKO OPTICAL INC.
Practice address
582 Central Ave
East Orange, NJ 07018-1936
Phone
(973) 674-3808
Fax
(973) 674-3943
NPI assigned
Mar 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
John KnollNPI 1538371273
Title
Owner
Phone
(973) 674-3808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 31TD180700 NJ Primary

Addresses

Primary practice location

582 Central Ave
East Orange, NJ 07018-1936

Mailing address

582 Central Ave
East Orange, NJ 07018-1936

Other identifiers 1

IdentifierTypeStateIssuer
6012809MedicaidNJ

National Provider Directory

National Provider Directory

Locations

582 Central Ave
East Orange, NJ 07018
Phone (973) 673-7700

Practitioners & affiliated clinicians

Practitioners 2

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": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1356512511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 CENTRAL AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 CENTRAL AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181936",
            "telephone_number": "973-674-3808",
            "fax_number": "973-674-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TKO OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "KNOLL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-674-3808"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NJ",
            "license": "31TD180700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6012809",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.