Healthcare Provider Details

I. General information

NPI: 1497377592
Provider Name (Legal Business Name): DELAWARE VALLEY FAMILY EYE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 LOWER FERRY RD
EWING NJ
08628-3525
US

IV. Provider business mailing address

1001 CITY AVE UNIT ED531
WYNNEWOOD PA
19096-3910
US

V. Phone/Fax

Practice location:
  • Phone: 609-883-6500
  • Fax:
Mailing address:
  • Phone: 732-804-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: SONAL PATEL
Title or Position: SECRETARY/TREASURER
Credential: OD
Phone: 609-883-6500