Provider Demographics
NPI:1447298062
Name:THE BRANDE SAAD GROUP
Entity type:Organization
Organization Name:THE BRANDE SAAD GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:CERVINO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-234-6060
Mailing Address - Street 1:421 E CALDER WAY
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-5663
Mailing Address - Country:US
Mailing Address - Phone:814-234-6060
Mailing Address - Fax:814-234-0797
Practice Address - Street 1:421 E CALDER WAY
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-5663
Practice Address - Country:US
Practice Address - Phone:814-234-6060
Practice Address - Fax:814-234-0797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No156FX1201XEye and Vision Services ProvidersTechnician/TechnologistOptometric AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0072092970002Medicaid
PA461594Medicare ID - Type Unspecified
PA0072092970002Medicaid