1902881576 NPI number — CARIM EYE AND RETINA CENTER LTD. P.C.

Table of content: (NPI 1902881576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902881576 NPI number — CARIM EYE AND RETINA CENTER LTD. P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARIM EYE AND RETINA CENTER LTD. 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:
1902881576
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2630 WESTVIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WYOMISSING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19610-1130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-376-1981
Provider Business Mailing Address Fax Number:
610-376-3153

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2630 WESTVIEW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WYOMISSING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19610-1130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-376-1981
Provider Business Practice Location Address Fax Number:
610-376-3153
Provider Enumeration Date:
12/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KURTZ
Authorized Official First Name:
JODI
Authorized Official Middle Name:
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
610-376-1981

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0019662670006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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