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General NPI Number Information
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NPI Number | 1841582483
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Entity Type | Organization
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Legal Business Name | ROBERT J STANGA OPTOMETRIST PC
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 11757 W KEN CARYL AVE STE. L
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City | LITTLETON
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State | CO
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Zip | 80127-3719
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Country | US
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Telephone | 303-904-4555
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Fax | 303-933-2981
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Provider Business Mailing Address
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Address Line | 11757 W KEN CARYL AVE STE. L
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City | LITTLETON
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State | CO
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Zip | 80127-3719
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Country | US
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Telephone | 303-904-4555
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Fax | 303-933-2981
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT STANGA
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Credential | O.D.
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Telephone | 303-904-4555
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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 | 2824
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License Number State | CO
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