1649240623 NPI number — NEW ERA OPTICAL INC

Table of content: (NPI 1649240623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649240623 NPI number — NEW ERA OPTICAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW ERA OPTICAL INC
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:
1649240623
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
350 NEW CHURCHMANS RD
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
NEW CASTLE
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19720-3112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-325-0180
Provider Business Mailing Address Fax Number:
302-325-0185

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 NEW CHURCHMANS RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19720-3112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-325-0180
Provider Business Practice Location Address Fax Number:
302-325-0185
Provider Enumeration Date:
01/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CLUFF
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
BESSIE
Authorized Official Title or Position:
OPTOMETRIST
Authorized Official Telephone Number:
302-325-0180

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  I3-1235 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 001483068 . This is a "AMEIHEALTH PPO" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 2173496000 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 915441 . This is a "BLOCK VISION" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 190965 . This is a "COVENTRY" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: DE1235 . This is a "EYEMED VISION" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: DE81235 . This is a "VISION BENEFITS OF AMERIC" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 7615486 . This is a "AETNA PPO" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1000023194 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 42708 . This is a "DAVIS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 375987 . This is a "MAMSI" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 18082 . This is a "SPECTERA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 3220693 . This is a "AETNA HMO" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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