Healthcare Provider Details

I. General information

NPI: 1952619108
Provider Name (Legal Business Name): LEHIGH VALLEY EYE CARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 W TILGHMAN ST SUITE 101
ALLENTOWN PA
18104-4354
US

IV. Provider business mailing address

2030 W TILGHMAN ST SUITE 101
ALLENTOWN PA
18104-4354
US

V. Phone/Fax

Practice location:
  • Phone: 610-432-3258
  • Fax: 610-289-2100
Mailing address:
  • Phone: 610-432-3258
  • Fax: 610-289-2100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOE-G002155
License Number StatePA

VIII. Authorized Official

Name: DR. R. DOUGLAS QUAY
Title or Position: MANAGING MEMBER
Credential: O.D.
Phone: 610-432-3258