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General NPI Number Information
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NPI Number | 1316351679
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Entity Type | Organization
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Legal Business Name | FAMILY EYE GROUP, P.C.
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 155 N READING RD
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City | EPHRATA
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State | PA
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Zip | 17522-1671
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Country | US
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Telephone | 717-735-1141
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Fax |
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Provider Business Mailing Address
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Address Line | 2110 HARRISBURG PIKE SUITE 215
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City | LANCASTER
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State | PA
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Zip | 17601-2644
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Country | US
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Telephone | 717-735-1141
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL PAVLICA
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Credential | M.D.
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Telephone | 717-735-1141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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