Organization
OPTICAL PALACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PARAG CHAMPAKLAL RAITHATHA OPTICIAN (PARTNER)
(201) 610-0980
Entity
Organization
Contact information
Practice address
910 BERGEN AVE, JERSEY CITY, NJ 07306-4314
(201) 610-0980
(201) 610-0982
Mailing address
910 BERGEN AVE, JERSEY CITY, NJ 07306-4314
(201) 610-0980
(201) 610-0982
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
TD3405
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8148805
—
NJ
Enumeration date
01/04/2007
Last updated
08/22/2020
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