Provider Demographics
NPI:1609934207
Name:OPTIKA EYECARE, INC.
Entity type:Organization
Organization Name:OPTIKA EYECARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIKI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-838-8190
Mailing Address - Street 1:25 KINNELON RD
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2337
Mailing Address - Country:US
Mailing Address - Phone:973-838-8190
Mailing Address - Fax:973-838-3230
Practice Address - Street 1:25 KINNELON RD
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2337
Practice Address - Country:US
Practice Address - Phone:973-838-8190
Practice Address - Fax:973-838-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00520400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ150665995OtherINSURANCE DESIGN ADMINIST
150665995OtherPHCS
NJOK9793OtherHEALTH NET
NJ150665995OtherWELLCHOICE OF NJ
NJP2391973OtherOXFORD HEALTH PLAN
NJP2391973OtherOXFORD HEALTH
NJ3571408OtherAETNA U.S. HEALTHCARE
NJDC9724OtherRAILROAD MEDICARE
NJ0672440001OtherDME MAC JURISDICTION A
NJOK9793OtherHEALTH NET
NJ=========OtherEYE MED
150665995OtherPHCS
NJ=========OtherCIGNA
NJ=========OtherBENESIGHT
NJ=========OtherUNITED HEALTHCARE
NJP2391973OtherOXFORD HEALTH PLAN
NJ150665995OtherWELLCHOICE OF NJ
NJ=========OtherQUALCARE
NJ=========OtherQUALCARE
NJP2391973OtherOXFORD HEALTH PLAN
NJ3571408OtherAETNA U.S. HEALTHCARE