Spare Pair IV

Primary specialty

OptometristTaxonomy code 152W00000X

License

5021 Issued in NJ

Legal business name

SPARE PAIR IV

Practice address

2145 Route 35
Holmdel, NJ 07733-1164

Phone

(732) 335-0004

Fax

(732) 335-0006

NPI assigned

Jul 18, 2008

Organization subpart

No

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

Authorized official

Name

John A Collini, OD

Title

VP

Phone

(732) 335-0004

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1376708313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 ROUTE 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331164",
            "telephone_number": "732-335-0004",
            "fax_number": "732-335-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 ROUTE 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331164",
            "telephone_number": "732-335-0004",
            "fax_number": "732-335-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARE PAIR IV",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "COLLINI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "732-335-0004",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "5021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.