1669856175 NPI number — DR. LAUREN BETH VIENT O.D.

Table of content: DR. LAUREN BETH VIENT O.D. (NPI 1669856175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669856175 NPI number — DR. LAUREN BETH VIENT O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VIENT
Provider First Name:
LAUREN
Provider Middle Name:
BETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ANDREAS
Provider Other First Name:
LAUREN
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
O.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669856175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
424 ANTHEM WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHALFONT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18914-1908
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:
620 GRAVEL PIKE
Provider Second Line Business Practice Location Address:
WALMART VISION CENTER
Provider Business Practice Location Address City Name:
EAST GREENVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18041-2130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-679-7902
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OEG003035 , 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)