Provider Demographics
NPI:1053518068
Name:VISION GALLERY INC.
Entity type:Organization
Organization Name:VISION GALLERY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRZEWOZNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-356-0300
Mailing Address - Street 1:611 W UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1165
Mailing Address - Country:US
Mailing Address - Phone:732-356-0300
Mailing Address - Fax:732-748-1550
Practice Address - Street 1:611 W UNION AVE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1165
Practice Address - Country:US
Practice Address - Phone:732-356-0300
Practice Address - Fax:732-748-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00129802156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4874260001Medicare NSC