Individual
MR. PARAG CHAMPKLAL RAITHATHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
1091B SPRINGFIELD AVE, IRVINGTON, NJ 07111-2408
(973) 416-6664
(973) 424-0072
Mailing address
1091B SPRINGFIELD AVE, IRVINGTON, NJ 07111-2408
(973) 416-6664
(973) 424-0072
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
TD3405
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105627
—
NJ
Enumeration date
07/27/2006
Last updated
07/09/2007
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