Eye Health Group of Princeton, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0600364695 Issued in NJ

Legal business name

EYE HEALTH GROUP OF PRINCETON, LLC

Practice address

205 Quaker Bridge Mall
Lawrenceville, NJ 08648

Phone

(609) 799-2285

Fax

(609) 799-2566

NPI assigned

Nov 16, 2010

Last updated

Nov 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randy S Nissinoff, ODNPI 1023061348

Title

Owner

Phone

(732) 505-0533

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randy S Nissinoff, OD

  • Optometrist
  • Toms River, NJ
  • NPI 1023061348
  NPD (past) Authorized official

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1538460977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1278 HOOPER AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087533343",
            "telephone_number": "732-505-0533",
            "fax_number": "732-505-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 QUAKER BRIDGE MALL",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "08648",
            "telephone_number": "609-799-2285",
            "fax_number": "609-799-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE HEALTH GROUP OF PRINCETON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "NISSINOFF",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-505-0533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "0600364695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.