Healthcare Provider Details

I. General information

NPI: 1205999778
Provider Name (Legal Business Name): SID SAVITT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 12/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29610 EUCLID AVE
WICKLIFFE OH
44092-1829
US

IV. Provider business mailing address

29610 EUCLID AVE
WICKLIFFE OH
44092-1829
US

V. Phone/Fax

Practice location:
  • Phone: 440-943-1993
  • Fax: 440-943-9595
Mailing address:
  • Phone: 440-943-1993
  • Fax: 440-943-9595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number3267
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3267
License Number StateOH

VIII. Authorized Official

Name: DR. SID E. SAVITT
Title or Position: OWNER
Credential: O.D.
Phone: 440-943-1993