Provider Demographics
NPI:1427159011
Name:GAIDA'S OPTICIANS,LLC
Entity type:Organization
Organization Name:GAIDA'S OPTICIANS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SUFKA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:320-252-2002
Mailing Address - Street 1:1545 NORTHWAY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1941
Mailing Address - Country:US
Mailing Address - Phone:320-252-2002
Mailing Address - Fax:320-253-8024
Practice Address - Street 1:1545 NORTHWAY DR STE 100
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1941
Practice Address - Country:US
Practice Address - Phone:320-252-2002
Practice Address - Fax:320-253-8024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN116807OtherU CARE
MN2126676OtherMEDICA
MN54332GAOtherBLUE PLUS
MN54332GAOtherBLUE PLUS