Specialty Eye Surgeon Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

SPECIALTY EYE SURGEON INC

Practice address

40 Union Ave Ste 106
Irvington, NJ 07111-3290

Phone

(908) 222-8700

NPI assigned

Dec 12, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Marietoni Ordono

Title

Credentialing Manager

Phone

(908) 222-8700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1801603907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 UNION AVE STE 106",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113290",
            "telephone_number": "908-222-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 UNION AVE STE 106",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113290",
            "telephone_number": "908-222-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY EYE SURGEON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "ORDONO",
        "authorized_official_first_name": "MARIETONI",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "908-222-8700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.