Organization
OPTICAL SOURCE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODIE COHEN (OWNER)
(732) 583-2800
Entity
Organization
Contact information
Practice address
349G MATAWAN RD, MATAWAN, NJ 07747-3907
(732) 583-2800
(732) 583-2829
Mailing address
349G MATAWAN RD, MATAWAN, NJ 07747-3907
(732) 583-2800
(732) 583-2829
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00364701
NJ
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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