Healthcare Provider Details

I. General information

NPI: 1124577341
Provider Name (Legal Business Name): EYE CARE ASSOCIATES OF PENNSYLVANIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2016
Last Update Date: 09/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 PAOLI PIKE
WEST CHESTER PA
19380-4527
US

IV. Provider business mailing address

4119 MAUCH CHUNK RD #C
COPLAY PA
18037-2106
US

V. Phone/Fax

Practice location:
  • Phone: 610-692-8300
  • Fax: 610-692-6007
Mailing address:
  • Phone: 610-799-2020
  • Fax: 610-799-4399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JILL JUSTICE
Title or Position: BILLINGER MANAGER
Credential:
Phone: 610-310-9946