Optical Palace2 LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

OPTICAL PALACE2 LLC

Practice address

461 Central Ave
Jersey City, NJ 07307-2740

Phone

(201) 420-1222

Fax

(201) 420-1369

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Mukul C Raithatha

Title

Owner

Phone

(201) 420-1222

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1912072273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072740",
            "telephone_number": "201-420-1222",
            "fax_number": "201-420-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072740",
            "telephone_number": "201-420-1222",
            "fax_number": "201-420-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL PALACE2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "RAITHATHA",
        "authorized_official_first_name": "MUKUL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-420-1222"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071811",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Jersey City, NJ
• Providers in Jersey City, 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 Jun 4, 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.