Innovision Optometry NJ PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

INNOVISION OPTOMETRY NJ PC

Doing business as

Elite Vision Eyecare

Practice address

63 W Pleasant Ave
Maywood, NJ 07607-1334

Phone

(201) 845-4700

NPI assigned

Oct 29, 2020

Last updated

Nov 3, 2020By 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

Dr. Ketan KutlerywalaNPI 1497861033

Title

President

Phone

(845) 541-9689

Specialties & licenses 1

Addresses

Other names 1

• Elite Vision Eyecare Doing business as

Practitioners 3

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.

• Ketan Harshadray Kutlerywala, OD

  • Optometrist
  • Maywood, NJ
  • NPI 1497861033
  NPD Authorized official
• Peter Heesung Yoon, OD

  • Optometrist
  • West Orange, NJ
  • NPI 1578135356
  NPD
• Charles M Shiel, OD

  • Optometrist
  • Maywood, NJ
  • NPI 1306848536
  NPD (past)

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1922608728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 WINDSOR HWY",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125536908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 W PLEASANT AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071334",
            "telephone_number": "201-845-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVISION OPTOMETRY NJ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "KUTLERYWALA",
        "authorized_official_first_name": "KETAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-541-9689",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Vision Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holistic Rehabilitation Services,PA
• Daniel Huy, PSY. D
• Carleen Implicito, LAC
• Dante Anthony Implicito, M.D.
• Infectious Diseases Associates of Northern New Jersey LLC
• Integrated Health and Medicine, LLC
• Allan V. Isip, PT, DPT
• Ashley L Jackson, LCSW
• James R Clifford MD PC
• Niren Jasutkar, M.D.

• Optometrist in Maywood, NJ
• Providers in Maywood, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.