Provision Eyecare Center

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

PROVISION EYECARE CENTER

Practice address

2010 Morris Ave
Union, NJ 07083-6014

Phone

(347) 683-1024

NPI assigned

Jan 23, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Ramon Lutero II

Title

Executive VP

Phone

(347) 683-1024

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1356849525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836014",
            "telephone_number": "347-683-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836014",
            "telephone_number": "347-683-1024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070524228",
            "country_code": "US",
            "telephone_number": "347-683-1024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVISION EYECARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "LUTERO",
        "authorized_official_first_name": "RAMON",
        "authorized_official_title_or_position": "EXECUTIVE VP",
        "authorized_official_telephone_number": "347-683-1024",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Union, NJ
• Providers in Union, NJ by specialty
• Medical Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.