Organization
FORT LEE VISION LLC
Active
Other names
Fort Lee Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE M. KIM O.D. (O.D./OWNER)
(201) 346-9000
Entity
Organization
Contact information
Practice address
2151 LEMOINE AVE, FORT LEE, NJ 07024-6041
(201) 346-9000
(201) 346-9001
Mailing address
2151 LEMOINE AVE, FORT LEE, NJ 07024-6041
(201) 346-9000
(201) 346-9001
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
27OA00602800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122874
—
NJ
Enumeration date
12/07/2009
Last updated
12/11/2014
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