Provider Demographics
NPI:1942350970
Name:SADO, WILLIAM GILBERT (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GILBERT
Last Name:SADO
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3898 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-6603
Mailing Address - Country:US
Mailing Address - Phone:330-220-2100
Mailing Address - Fax:330-273-5534
Practice Address - Street 1:3898 CENTER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-6603
Practice Address - Country:US
Practice Address - Phone:330-220-2100
Practice Address - Fax:330-273-5534
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS2102156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician