Healthcare Provider Details

I. General information

NPI: 1013135821
Provider Name (Legal Business Name): MOORE EYE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W SPROUL RD SUITE 125
SPRINGFIELD PA
19064-2033
US

IV. Provider business mailing address

100 W SPROUL RD HEALTHPLEX PAVILION II - SUITE 125
SPRINGFIELD PA
19064-2033
US

V. Phone/Fax

Practice location:
  • Phone: 610-544-0500
  • Fax: 610-690-4900
Mailing address:
  • Phone: 610-544-0500
  • Fax: 610-690-1659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD BRILLIANT
Title or Position: LOW VISION SPECIALIST
Credential: O.D.
Phone: 610-544-0500