DP 17 Optometric Associates

Primary specialty

OptometristTaxonomy code 152W00000X

License

27040552800 Issued in NJ

Legal business name

DP 17 OPTOMETRIC ASSOCIATES

Practice address

494 N Rte 17
Paramus, NJ 07652-3012

Phone

(201) 599-1102

Fax

(201) 599-1202

NPI assigned

May 1, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Michelle Fraser, O.D.NPI 1023163185

Title

Optometrist

Phone

(201) 599-1102

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Rene Fraser

  • Optometrist
  • Paramus, NJ
  • NPI 1023163185
  NPD (past) Authorized official

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1912384652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "494 N RTE 17",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523012",
            "telephone_number": "201-599-1102",
            "fax_number": "201-599-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "494 N RTE 17",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523012",
            "telephone_number": "201-599-1102",
            "fax_number": "201-599-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DP 17 OPTOMETRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "201-599-1102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27040552800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mary Louise Doyle, RN
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• Optometrist in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.