Organization
JEROLD OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA ELLEN RUBIN L.D.O. (PRESIDENT)
(216) 781-7900
Entity
Organization
Contact information
Practice address
800 HURON RD E, CLEVELAND, OH 44115-1121
(216) 781-7900
(216) 781-0554
Mailing address
800 HURON RD., CLEVELAND, OH 44115-1121
(216) 781-7900
(216) 781-0554
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1267-S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4360507
—
OH
Enumeration date
02/02/2007
Last updated
07/06/2015
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