Individual provider Active NPI

Emma Mutz, OPTICIAN

  • Optician
  • Riverdale, NJ
National Provider Identifier
1649448655
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
31TD00305000 Issued in NJ
Practice address
92 Rte23N
Suite E
Riverdale, NJ 07457
Phone
(973) 248-1188
Fax
(973) 248-1125
NPI assigned
Feb 12, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 31TD00305000 NJ Primary

Addresses

Primary practice location

92 Rte23N
Suite E
Riverdale, NJ 07457

Mailing address

92 Rte 23 N
Suite E
Riverdale, NJ 07457
Phone (973) 248-1188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31TD00305000NJMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1649448655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 RTE 23 N",
            "address_2": "SUITE E",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "07457",
            "telephone_number": "973-248-1188",
            "fax_number": "973-248-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 RTE23N",
            "address_2": "SUITE E",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "07457",
            "telephone_number": "973-248-1188",
            "fax_number": "973-248-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTZ",
        "first_name": "EMMA",
        "name_prefix": "Mrs.",
        "credential": "OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": "31TD00305000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.