Mdo Optical, Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

TD3639 Issued in NJ

Legal business name

MDO OPTICAL, INC

Practice address

180 Route 35
Eatontown, NJ 07724-2023

Phone

(732) 542-6060

Fax

(732) 389-0069

NPI assigned

Mar 1, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Maksim Grinberg

Title

President

Phone

(732) 542-6060

Specialties & licenses 1

Addresses

Other names 1

• Cohen's Fashion Optical Doing business as

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1760756282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ROUTE 35",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077242023",
            "telephone_number": "732-542-6060",
            "fax_number": "732-389-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ROUTE 35",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077242023",
            "telephone_number": "732-542-6060",
            "fax_number": "732-389-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDO OPTICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "GRINBERG",
        "authorized_official_first_name": "MAKSIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-542-6060",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NJ",
            "license": "TD3639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cohen's Fashion Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cheyenne Mazza
• Elaine McCarron, PT,OT
• Emmi McCauley, LAC
• Michael A McNeill
• Kristen Lee McQueen
• Medcare Wa
• Marc Mehlman, D.M.D.
• Malka Meltzer, COTA/L
• Kimberly Ann Menck, LAC
• Ashley Menichini

• Eyewear Supplier in Eatontown, NJ
• Providers in Eatontown, NJ by specialty
• Eyewear Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.