Provider Demographics
NPI:1366484081
Name:SAUS, PAMELA A (OD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:A
Last Name:SAUS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:A
Other - Last Name:VITALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:170 ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5756
Mailing Address - Country:US
Mailing Address - Phone:908-782-2224
Mailing Address - Fax:
Practice Address - Street 1:255 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-1807
Practice Address - Country:US
Practice Address - Phone:732-752-6222
Practice Address - Fax:732-752-2030
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00574600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
151098Medicare PIN