1982763124 NPI number — STARER RIZZO RUFFINI OPHTHALMIC ASSOCIATES, P.C.

Table of content: (NPI 1982763124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982763124 NPI number — STARER RIZZO RUFFINI OPHTHALMIC ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STARER RIZZO RUFFINI OPHTHALMIC ASSOCIATES, P.C.
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:
1982763124
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1510 CHESTER PIKE STE 701
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDDYSTONE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19022-1384
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-521-2111
Provider Business Mailing Address Fax Number:
610-521-3048

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1510 CHESTER PIKE STE 701
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDDYSTONE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19022-1384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-521-2111
Provider Business Practice Location Address Fax Number:
610-521-3048
Provider Enumeration Date:
12/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NAIMOLI
Authorized Official First Name:
DOREEN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
610-521-2111

Provider Taxonomy Codes

  • 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)

  • Identifier: 31269 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 36784 . This is a "DAVIS VISION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 952194 . This is a "BC BS OPTOMETRY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 036886000 . This is a "KHPE OPTOMETRY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 661068 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 661068 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0493281000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 051846001 . This is a "DMERC" identifier . This identifiers is of the category "OTHER".




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