Healthcare Provider Details

I. General information

NPI: 1568798148
Provider Name (Legal Business Name): STERLING OPTICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 11/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 QUENTIN ROOSEVELT BLVD STE 508
GARDEN CITY NY
11530-4874
US

IV. Provider business mailing address

55 PARSONAGE RD UNIT 368B
EDISON NJ
08837-2480
US

V. Phone/Fax

Practice location:
  • Phone: 516-390-2115
  • Fax: 516-390-2170
Mailing address:
  • Phone: 732-906-8081
  • Fax: 732-906-7995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number
License Number State

VIII. Authorized Official

Name: AMY SHAPIRO
Title or Position: DIRECTOR
Credential:
Phone: 516-390-2115