Organization
PRO-VAC, INC
Active
Other names
able opticians
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDITH CARLETTA OPTICIAN (VICE PRESIDANT/OPTICIAN)
(732) 892-7717
Entity
Organization
Contact information
Practice address
2315 BRIDGE AVE, POINT PLEASANT BORO, NJ 08742-4329
(732) 892-7717
(732) 892-7836
Mailing address
2315 BRIDGE AVE, POINT PLEASANT BORO, NJ 08742-4329
(732) 892-7717
(732) 892-7836
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
31TD00300700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02719
SPECTERA
NJ
01
—
110308
EYE MED
NJ
01
—
1K8390
HEALTH NET
NJ
01
—
313227
NVA
NJ
05
—
8577803
—
NJ
Enumeration date
02/07/2008
Last updated
04/20/2008
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