1154486116 NPI number — CHESTER COUNTY EYE CARE ASSOCIATES, PC

Table of content: (NPI 1154486116)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154486116 NPI number — CHESTER COUNTY EYE CARE ASSOCIATES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHESTER COUNTY EYE CARE ASSOCIATES, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154486116
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 MCFARLAN RD
Provider Second Line Business Mailing Address:
BLDG. 1, SUITE 3
Provider Business Mailing Address City Name:
KENNETT SQUARE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19348-2477
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-723-2034
Provider Business Mailing Address Fax Number:
610-918-0803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 MCFARLAN RD
Provider Second Line Business Practice Location Address:
BLDG. 1, SUITE 3
Provider Business Practice Location Address City Name:
KENNETT SQUARE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19348-2477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-723-2034
Provider Business Practice Location Address Fax Number:
610-918-0803
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SARAN
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
610-444-8075

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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