1063499531 NPI number — LUDWICK EYE CENTER, LTD

Table of content: (NPI 1063499531)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063499531 NPI number — LUDWICK EYE CENTER, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUDWICK EYE CENTER, LTD
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:
1063499531
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
825 FIFTH AVE
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-4220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-262-9700
Provider Business Mailing Address Fax Number:
717-264-6522

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 FIFTH AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-4220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-262-9700
Provider Business Practice Location Address Fax Number:
717-264-6522
Provider Enumeration Date:
12/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ARONSKY
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
717-262-9700

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OEG000873 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: OEG000006 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: MD037338E , 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: DF2342 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: CG7940 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0015389300009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 404603000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: DA7401 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 180032028 . This is a "RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 406230200 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0015389300008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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