Provider Demographics
NPI:1750328175
Name:SAR OPTIQUE, INC
Entity Type:Organization
Organization Name:SAR OPTIQUE, INC
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:SPIVACK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:856-227-4555
Mailing Address - Street 1:1500 ALMONESSON RD
Mailing Address - Street 2:UNIT D16
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-5259
Mailing Address - Country:US
Mailing Address - Phone:856-227-4555
Mailing Address - Fax:856-232-7577
Practice Address - Street 1:1500 ALMONESSON RD
Practice Address - Street 2:UNIT D16
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-5259
Practice Address - Country:US
Practice Address - Phone:856-227-4555
Practice Address - Fax:856-232-7577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA04625332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT30124Medicare UPIN
NJ218246Medicare PIN