Coopercrwn NJ

Primary specialty

OptometristTaxonomy code 152W00000X

License

270A00465400 Issued in NJ

Legal business name

COOPERCRWN NJ

Practice address

225 Broad Ave
Suite#206
Palisades Park, NJ 07650-1588

Phone

(201) 585-1337

Fax

(201) 585-2998

NPI assigned

Oct 2, 2007

Last updated

Apr 15, 2021By 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

Sean Kim

Title

President

Phone

(201) 731-3587

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Best vision Other name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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.

• Larry Wang, OD

  • Optometrist
  • Garfield, NJ
  • NPI 1366917064
  Medicare reassignment NPD
• Taewha Carolyn Moon, O.D.

  • Optometrist
  • Palisades Park, NJ
  • NPI 1972603637
  Medicare reassignment

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1801083050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BROAD AVE",
            "address_2": "SUITE#206",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501588",
            "telephone_number": "201-585-1337",
            "fax_number": "201-585-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROAD AVE",
            "address_2": "SUITE#206",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501588",
            "telephone_number": "201-585-1337",
            "fax_number": "201-585-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPERCRWN NJ",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-731-3587"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "270A00465400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5084601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Best vision",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Best vision",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Michael Y Chung, DDS
• Cici Pharmacy (Serom pharmacy 1)
• Clearview Diagnostics Center Inc
• Samuel Colato
• Dana M Colthart, LSW
• Daniel Y. Kim, M.D., P.a.
• Dev DC Inc. (Richard's Pharmacy)
• Dev DC Inc. (richards pharmac y)
• Downtown Vein and Vascular of Penn PLLC
• Dr Bo Shin, LLC

• Optometrist in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.