Organization
RIVERDALE VISION CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUDAPORN TANPATTANA O.D. (OPTOMETRIST)
(917) 623-7129
Entity
Organization
Contact information
Practice address
92 ROUTE 23 NORTH, SUITE E, RIVERDALE, NJ 07457
(917) 623-7129
Mailing address
105 GREENE ST, APT 1502, JERSEY CITY, NJ 07302-3848
(917) 623-7129
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA 00594603
NJ
Other
Enumeration date
09/23/2008
Last updated
02/25/2009
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