| Organization Name: | GREEN BROOK VISION ASSOCIATES INC |
| NPI Number: | 1053518613 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESTER FRANKEL (OPTICIAN) |
| Mailing Address: | 328 Greenbrook Rd Green Brook |
| State: | NJ US |
| Postal Code: | 088122200 |
| Phone Number: | 7323563060 |
| Fax Number: | 7328053032 |
| NPI Enumeration Date: | 06/28/2007 |
| NPI Last Update Date: | 12/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 31TD00129802 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |