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General NPI Number Information
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NPI Number | 1417092545
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Entity Type | Organization
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Legal Business Name | S & A OPTICAL, INC.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 400 COMMONS WAY SUITE 354
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-2800
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Country | US
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Telephone | 908-725-0008
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Fax |
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Provider Business Mailing Address
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Address Line | 400 COMMONS WAY SUITE 354
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City | BRIDGEWATER
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State | NJ
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Zip | 08807-2800
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Country | US
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Telephone | 908-725-0008
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ALEKSEY ZHUKOV
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Credential |
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Telephone | 908-725-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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