1881963874 NPI number — YARDLEY VISION CARE INC

Table of content: (NPI 1881963874)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881963874 NPI number — YARDLEY VISION CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YARDLEY VISION CARE 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:
1881963874
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1790 YARDLEY LANGHORNE RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
YARDLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19067-5523
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-493-1924
Provider Business Mailing Address Fax Number:
215-493-9805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1790 YARDLEY LANGHORNE RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
YARDLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19067-5523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-493-1924
Provider Business Practice Location Address Fax Number:
215-493-9805
Provider Enumeration Date:
12/20/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MAISEL
Authorized Official First Name:
SHEILA
Authorized Official Middle Name:
COE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
214-493-1924

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OE008487T , 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: 1295903896 . This is a "NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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