Organization
OPTICAL WORLD OF ELIZABETH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKUL C RAITHATHA (PRESIDENT)
(908) 629-0011
Entity
Organization
Contact information
Practice address
206 BROAD ST, ELIZABETH, NJ 07201-2304
(908) 629-0011
(908) 629-1133
Mailing address
206 BROAD ST, ELIZABETH, NJ 07201-2304
(908) 629-0011
(908) 629-1133
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072460
—
NJ
01
—
28188
SPECTERA
NJ
01
—
51599
DAVIS VISION
NJ
Enumeration date
08/14/2006
Last updated
12/02/2008
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