Provider Demographics
NPI:1225161870
Name:SAP OPTICAL
Entity Type:Organization
Organization Name:SAP OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-846-1144
Mailing Address - Street 1:10222 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-1739
Mailing Address - Country:US
Mailing Address - Phone:718-846-1144
Mailing Address - Fax:718-849-1146
Practice Address - Street 1:10222 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-1739
Practice Address - Country:US
Practice Address - Phone:718-846-1144
Practice Address - Fax:718-849-1146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Not Answered332H00000XSuppliersEyewear Supplier