1124353172 NPI number — CHESTER COUNTY EYE CARE ASSOCIATES, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124353172 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:
1124353172
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
915 OLD FERN HILL RD
Provider Second Line Business Mailing Address:
BUILDING B, SUITE 200
Provider Business Mailing Address City Name:
WEST CHESTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19380-4269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-696-1230
Provider Business Mailing Address Fax Number:
610-918-0803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1011 W BALTIMORE PIKE
Provider Second Line Business Practice Location Address:
SUITE 303
Provider Business Practice Location Address City Name:
WEST GROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19390-9446
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-696-1230
Provider Business Practice Location Address Fax Number:
610-918-0803
Provider Enumeration Date:
10/08/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SARAN
Authorized Official First Name:
BRUCE
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
610-696-1230

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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