Organization
PASSAIC VISION CENTER ,LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS MENDOZA MD (OWNER)
(973) 473-5151
Entity
Organization
Contact information
Practice address
289 MONROE ST., PASSAIC VISION CENTER, PASSAIC, NJ 07055-5209
(973) 473-5151
(973) 473-3331
Mailing address
PO BOX 1758, CLIFTON, NJ 07015-1758
(973) 473-5151
(973) 473-3331
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054721
—
NJ
Enumeration date
10/03/2007
Last updated
11/22/2013
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