| Organization Name: | THE LASIK VISION INSTITUTE LLC |
| NPI Number: | 1083030076 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BEN COOK (PRESIDENT) |
| Mailing Address: | 336 West Passaic Street Suite 202 Rochelle Park |
| State: | NJ US |
| Postal Code: | 07662 |
| Phone Number: | 2012260127 |
| Fax Number: | |
| NPI Enumeration Date: | 03/14/2014 |
| NPI Last Update Date: | 03/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS0132X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ophthalmologic Surgery |
| Taxonomy Definition: | |