Individual
KHALID OSMAN BANGA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
570 N BROAD ST STE A, ELIZABETH, NJ 07208-4301
(908) 344-6291
Mailing address
570 N BROAD ST STE A, ELIZABETH, NJ 07208-4301
(908) 344-6291
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
31TD00396000
NJ
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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