Healthcare Provider Details

I. General information

NPI: 1417973959
Provider Name (Legal Business Name): BETHLEHEM EYE CARE ASSOCIATES, P. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

547 MAIN ST
BETHLEHEM PA
18018-5810
US

IV. Provider business mailing address

547 MAIN ST
BETHLEHEM PA
18018-5810
US

V. Phone/Fax

Practice location:
  • Phone: 610-866-5815
  • Fax: 610-866-2450
Mailing address:
  • Phone: 610-866-5815
  • Fax: 610-866-2450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY A. KRASNICKE
Title or Position: PRESIDENT
Credential: O.D.
Phone: 610-866-5815