MEDICARE: NORTH PARK OPTICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	S.2101	OH

General Provider Information

NPI Number	:	1164686267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH PARK OPTICAL

Provider Business Mailing Address
First Line	:	20670 N PARK BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-4519
Country	:	US
Telephone Number	:	216-371-3242
Fax Number	:	216-371-1510

Provider Business Practice Location Address
First Line	:	20670 N PARK BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-4519
Country	:	US
Telephone Number	:	216-371-3242
Fax Number	:	216-371-1510

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT SAIGER
Credential	:	OPTICIAN
Telephone Number	:	216-371-3242

Provider Enumeration Date	:	07/17/2008
Last Update Date	:	12/08/2008

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Directions to “NORTH PARK OPTICAL ” Practice Location

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