1184699100 NPI number — OCEAN EYE ASSOCIATES, INC

Table of content: (NPI 1184699100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184699100 NPI number — OCEAN EYE ASSOCIATES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OCEAN EYE ASSOCIATES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DR CINDY J FAILLA RADO
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184699100
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 BRICK MALL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08723-4163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-341-1600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 BRICK MALL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08723-4163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-341-1600
Provider Business Practice Location Address Fax Number:
732-534-0095
Provider Enumeration Date:
02/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FAILLA RADO
Authorized Official First Name:
CINDY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OPTOMETRIST PRESIDENT
Authorized Official Telephone Number:
732-341-1600

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  270A00536600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152W00000X , with the licence number: 27T00068800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2245958 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 816282 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 410034589 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8017301 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: C1975 . This is a "EMPIRE BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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