MEDICARE: SIGHT SAVER OCEAN

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	152W00000X	Optometrist	27OA005921	NJ

General Provider Information

NPI Number	:	1710426507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIGHT SAVER OCEAN

Provider Business Mailing Address
First Line	:	1358 HOOPER AVE
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2882
Country	:	US
Telephone Number	:	732-505-4444
Fax Number	:	732-505-1068

Provider Business Practice Location Address
First Line	:	1358 HOOPER AVE
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2882
Country	:	US
Telephone Number	:	732-505-4444
Fax Number	:	732-505-1068

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM FRIDEL III
Credential	:	O.D.
Telephone Number	:	732-505-4444

Provider Enumeration Date	:	02/14/2017
Last Update Date	:	02/14/2017

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Directions to “SIGHT SAVER OCEAN ” Practice Location

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