Sudakov, Paul
Sudakov, Paul is an individual health care provider with primary practice located at 335 George Street Optical Boutique, New Brunswick NJ 08901. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Sudakov, Paul can be contacted via phone (732) 246-6895.Contact Information
Primary practice address
335 George Street Optical Boutique
New Brunswick NJ 08901
Phone: (732) 246-6895
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 31TD00317100 | New Jersey |
Profile Details
| NPI number | 1659516904 |
|---|---|
| LBN Legal business name | Sudakov, Paul |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2008 |
| Last updated | Dec 15th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659516904 | NPPES |
| New Jersey | MEDICAID | 0615441 |
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