Organization
PAVONIA OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN LURIE OPHTHALMIC DISPENSER (MANAGER)
(201) 963-9187
Entity
Organization
Contact information
Practice address
600 PAVONIA AVE, 6TH FLOOR, JERSEY CITY, NJ 07306-2929
(201) 963-9187
Mailing address
600 PAVONIA AVE, 6TH FLOOR, JERSEY CITY, NJ 07306
(201) 963-9187
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
31TD00155100
NJ
Other
Enumeration date
10/15/2007
Last updated
12/14/2007
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