| Organization Name: | OPTICAL VISION |
| NPI Number: | 1053536292 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOAQUIN ARMANDO RODRIGUEZ (OPTICIAN) |
| Mailing Address: | 4414 Bergenline Ave Union City |
| State: | NJ US |
| Postal Code: | 070875004 |
| Phone Number: | 2013300123 |
| Fax Number: | 2012711630 |
| NPI Enumeration Date: | 04/14/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 31TD00153100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |