Provider Demographics
NPI:1841582483
Name:ROBERT J STANGA OPTOMETRIST PC
Entity Type:Organization
Organization Name:ROBERT J STANGA OPTOMETRIST PC
Other - Org Name:ADVANCED FAMILY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STANGA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:303-904-4555
Mailing Address - Street 1:11757 W KEN CARYL AVE
Mailing Address - Street 2:STE. L
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-3719
Mailing Address - Country:US
Mailing Address - Phone:303-904-4555
Mailing Address - Fax:303-933-2981
Practice Address - Street 1:11757 W KEN CARYL AVE
Practice Address - Street 2:STE. L
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-3719
Practice Address - Country:US
Practice Address - Phone:303-904-4555
Practice Address - Fax:303-933-2981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2824152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty