1568855229 NPI number — JORMAT OPTOMETRIC ASSOCIATES, PC

Table of content: CAARA HIRSCH LEINTZ PA (NPI 1245862846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568855229 NPI number — JORMAT OPTOMETRIC ASSOCIATES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JORMAT OPTOMETRIC 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:
1568855229
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1165 HOLLOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENN VALLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19072-1155
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7516 CITY AVE
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19151-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-878-7181
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KARLINER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-304-4724

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  PA 6898T , 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)





Copyright © 2007-2025 www.npivalidator.com