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General NPI Number Information
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NPI Number | 1215265723
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Entity Type | Organization
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Legal Business Name | EVERLASTING EYE CARE, P.C.
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 07/20/2010
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Provider Practice Location Address
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Address Line | 222 W RIDGE PIKE
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City | LIMERICK
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State | PA
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Zip | 19468-1716
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Country | US
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Telephone | 610-990-3097
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Fax |
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Provider Business Mailing Address
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Address Line | 151 CHURCH STREET
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City | MOUNTVILLE
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State | PA
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Zip | 17554-1421
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Country | US
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Telephone | 360-908-8154
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MYAN THI NGUYEN
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Credential | OPTOMETRIST
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Telephone | 360-908-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OEG001966
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License Number State | PA
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