Provider Demographics
NPI:1164686267
Name:NORTH PARK OPTICAL
Entity Type:Organization
Organization Name:NORTH PARK OPTICAL
Other - Org Name:PARK OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIGER
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:216-371-3242
Mailing Address - Street 1:20670 N PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4519
Mailing Address - Country:US
Mailing Address - Phone:216-371-3242
Mailing Address - Fax:216-371-1510
Practice Address - Street 1:20670 N PARK BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44118-4519
Practice Address - Country:US
Practice Address - Phone:216-371-3242
Practice Address - Fax:216-371-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2101156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5495970001Medicare NSC