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General NPI Number Information
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NPI Number | 1265964522
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Entity Type | Organization
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Legal Business Name | MORAN EYE ASSOCIATES, P.C.
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 06/13/2017
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Provider Practice Location Address
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Address Line | 1204 DELAWARE AVE
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-4119
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Country | US
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Telephone | 610-628-2022
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 DELAWARE AVE
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-4119
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Country | US
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Telephone | 610-628-2022
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK E MORAN
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Credential | D.O.
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Telephone | 610-628-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | OS006169L
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License Number State | PA
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