Antonacos, Spiro

Antonacos, Spiro is an sole proprietor health care provider with primary practice located at 582 Central Ave , East Orange NJ 07018-1936. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Antonacos, Spiro can be contacted via phone (973) 673-7700.

Contact Information

Primary practice address
582 Central Ave East Orange NJ 07018-1936
Fax: (973) 674-3943
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 27OA00511900 New Jersey

Profile Details

NPI number 1174643688
LBN Legal business name Antonacos, Spiro
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 29th, 2007
Last updated Jun 20th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174643688 NPPES
New Jersey MEDICAID 4997000

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