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General NPI Number Information
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NPI Number | 1043306533
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Entity Type | Individual
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Provider Name | JOHN SAQA OD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 100 N MAIN ST WALMART VISION CENTER
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City | MANVILLE
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State | NJ
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Zip | 08835-1358
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Country | US
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Telephone | 908-575-9446
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Fax |
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Provider Business Mailing Address
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Address Line | 100 NORTH MAIN ST. WALMART VISION CENTER
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City | MANVILLE
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State | NJ
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Zip | 08835-0000
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Country | US
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Telephone | 908-575-9446
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00550400
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License Number State | NJ
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