PAUL SUDAKOV NPI 1659516904

NPI Information

NPI: 1659516904
Provider Name: PAUL SUDAKOV
Classification: Technician/Technologist - 156FX1800X
Entity Type: Individual

Specialization: Optician

Address:
335 GEORGE STREET
OPTICAL BOUTIQUE
NEW BRUNSWICK, NJ
ZIP 08901
Phone: (732) 246-6895
Get Directions

Paul Sudakov is an optician technician technologist in New Brunswick, NJ. The provider is opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy. Paul Sudakov NPI is 1659516904. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

335 GEORGE STREET
OPTICAL BOUTIQUE
NEW BRUNSWICK, NJ
ZIP 08901
Phone: (732) 246-6895

The enumeration date for this NPI number is 12/15/2008 and was last updated on 12/15/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	156FX1800X	Technician/Technologist	Optician	31TD00317100	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0615441	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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