NPIMap

Organization Active NPI

MJ Optometry Group, PC

  • Optometrist
  • Palisades Park, NJ
National Provider Identifier
1992046759
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
27OA00604800 Issued in NJ
Legal business name
MJ OPTOMETRY GROUP, PC
Practice address
571 Windsor Dr
Palisades Park, NJ 07650-2363
Phone
(201) 421-9319
Fax
(201) 482-8543
NPI assigned
Mar 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Dr. Martin Sung Kim, ODNPI 1801827795
Title
President
Phone
(201) 421-9319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 27OA00604800 NJ Primary

Addresses

Primary practice location

571 Windsor Dr
Palisades Park, NJ 07650-2363

Mailing address

571 Windsor Dr
Palisades Park, NJ 07650-2363
Phone (201) 421-9319

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1992046759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 WINDSOR DR",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502363",
            "telephone_number": "201-421-9319",
            "fax_number": "201-482-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 WINDSOR DR",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502363",
            "telephone_number": "201-421-9319",
            "fax_number": "201-482-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJ OPTOMETRY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "SUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-421-9319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00604800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palisades Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.