MEDICARE: HANI F SADDIC ABOC/ NCLEC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FC0801X	Contact Lens Fitter	6292SC	OH
2	156FX1800X	Optician	6292SC	OH

General Provider Information

NPI Number	:	1841528049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANI F SADDIC ABOC/ NCLEC

Provider Business Mailing Address
First Line	:	5311 NORTHFIELD RD STE 6
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-1135
Country	:	US
Telephone Number	:	216-662-1160
Fax Number	:	216-662-1161

Provider Business Practice Location Address
First Line	:	5311 NORTHFIELD RD STE 6
Second Line	:
City	:	BEDFORD HTS
State	:	OH
Zip	:	44146-1135
Country	:	US
Telephone Number	:	216-662-1160
Fax Number	:	216-662-1161

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2009
Last Update Date	:	11/27/2009

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