Organization
ISLAND OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY NISSINOFF (OWNER)
(732) 505-0533
Entity
Organization
Contact information
Practice address
525 AVE FD ROOSEVELT, PLAZA LAS AMERICAS SUITE 140, SAN JUAN, PR 00918-8020
(787) 753-1033
Mailing address
275 ROUTE 22, SPRINGFIELD, NJ 07081-3554
(732) 505-0533
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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