Healthcare Provider Details

I. General information

NPI: 1164500229
Provider Name (Legal Business Name): TRI-STATE FAMILY EYE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 CHURCH LANE
YEADON PA
19050-3102
US

IV. Provider business mailing address

538 CHURCH LANE
YEADON PA
19050-3102
US

V. Phone/Fax

Practice location:
  • Phone: 610-284-0777
  • Fax:
Mailing address:
  • Phone: 610-284-0777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. DONNA LEONNE ELCOCK
Title or Position: PRESIDENT/ OPTOMETRIST
Credential: O.D.
Phone: 610-284-0777