Provider Demographics
NPI:1134118433
Name:SABHERWAL, HARJINDER S (DISPENSING OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:HARJINDER
Middle Name:S
Last Name:SABHERWAL
Suffix:
Gender:M
Credentials:DISPENSING OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-1846
Mailing Address - Country:US
Mailing Address - Phone:814-825-2984
Mailing Address - Fax:814-825-2984
Practice Address - Street 1:1164 E 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-1846
Practice Address - Country:US
Practice Address - Phone:814-825-2984
Practice Address - Fax:814-825-2984
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000001743156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00284867OtherHIGHMARK OPTI-CHOICE
PA284867OtherBLUE CHIP
PAPA0109OtherEYEMEDVISIONCARE
PA0005687010001OtherPUBLIC ASSISTANCE