1659573590 NPI number — SUSAN PRZETAK-CASE, O.D. P.A.

Table of content: (NPI 1659573590)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659573590 NPI number — SUSAN PRZETAK-CASE, O.D. P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUSAN PRZETAK-CASE, O.D. P.A.
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:
THE FOCAL POINT
Provider Other Organization Name Type Code:
3
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:
1659573590
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/26/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
440 ROUTE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOWACO
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07082
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-316-2626
Provider Business Mailing Address Fax Number:
973-316-3066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
440 ROUTE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOWACO
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07082-1288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-316-2626
Provider Business Practice Location Address Fax Number:
973-316-3066
Provider Enumeration Date:
06/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PRZETAK-CASE
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
973-316-2626

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  27OA00485600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com