Organization
OPTICAL PALACE OF NEWARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PARAG CHAMPAKLAL RAITHATHA OPTICIAN (V.PRESIDENT)
97342420070
Entity
Organization
Contact information
Practice address
89 MARKET ST, NEWARK, NJ 07102-1736
(973) 424-0070
(973) 424-0072
Mailing address
89 MARKET ST, NEWARK, NJ 07102-1736
(973) 424-0070
(973) 424-0072
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
TD3405
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105619
—
NJ
Enumeration date
11/02/2006
Last updated
08/22/2020
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