Provider Demographics
NPI:1639405707
Name:JULDEC
Entity Type:Organization
Organization Name:JULDEC
Other - Org Name:STERLING OPTICAL 169
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRONWYN
Authorized Official - Middle Name:SYLVIA
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-371-1881
Mailing Address - Street 1:22 CLIFTON COUNTRY RD
Mailing Address - Street 2:CLIFTON PARK CENTER
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3832
Mailing Address - Country:US
Mailing Address - Phone:518-371-1881
Mailing Address - Fax:
Practice Address - Street 1:22 CLIFTON COUNTRY RD
Practice Address - Street 2:CLIFTON PARK CENTER
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3832
Practice Address - Country:US
Practice Address - Phone:518-371-1881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty