Healthcare Provider Details

I. General information

NPI: 1013958313
Provider Name (Legal Business Name): EAST PENN EYE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 10/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 WESTGATE DR SUITE 300
BETHLEHEM PA
18017-7480
US

IV. Provider business mailing address

2045 WESTGATE DR SUITE 300
BETHLEHEM PA
18017-7480
US

V. Phone/Fax

Practice location:
  • Phone: 610-867-1182
  • Fax: 610-866-2196
Mailing address:
  • Phone: 610-867-1182
  • Fax: 610-866-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberOEG000088
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000088
License Number StatePA

VIII. Authorized Official

Name: DR. MARK A SPERING
Title or Position: PRESIDENT/CEO
Credential: O.D.
Phone: 610-867-1182