Provider Demographics
NPI:1669030326
Name:ELIZABETH OPTOMETRIC GROUP
Entity Type:Organization
Organization Name:ELIZABETH OPTOMETRIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-436-0572
Mailing Address - Street 1:230 W JERSEY ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-1352
Mailing Address - Country:US
Mailing Address - Phone:908-436-0572
Mailing Address - Fax:908-352-4752
Practice Address - Street 1:230 W JERSEY ST STE 201
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1352
Practice Address - Country:US
Practice Address - Phone:908-436-0572
Practice Address - Fax:908-352-4752
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KLEIN & SCANNAPIEGO, MD.,PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty